Q: Who is most likely to get breast cancer?

A: Breast cancer occurs most often in women over 40 and the risk increases with age. There are many things that may increase a woman's risk of breast cancer. Some of these are things that cannot be controlled and others are lifestyle choices that can be controlled. Some things may cause large increases in risk and some may result in small increases in risk.

Risk factors that cannot be controlled include carrying a breast cancer gene and having a long, uninterrupted menstrual history. Families who carry a breast cancer gene tend to have several members with breast cancer and it is often diagnosed before menopause. These families may also have cancers of the endometrium, ovary, or colon. A long, uninterrupted menstrual history includes menstruation that begins at an early age, menopause starting at a late age, not having children, or first pregnancy at late age.

Risk factors that can be controlled include the use of postmenopausal estrogen, alcohol use (more than one drink a day), postmenopausal obesity, and smoking. The role of diet as a breast cancer risk factor is unclear at this time. Lifestyle risk factors may be of the most importance to women already at high risk due to family history and breast cancer gene presence.

Q: Can breast cancer be prevented?

A: There is no sure way to prevent breast cancer. All women can consider the lifestyle risk factors as they make their choices. The answers are not all in on this subject and women need to stay informed as new research is published. For women who are at higher-than-average risk, tamoxifen and raloxifene have been approved in the United States to reduce their risk of developing breast cancer. These hormonal treatments have side effects and risks, so the decision to use one of them for prevention should be made in careful consultation with a doctor. It is likely others will be approved in the future, based on ongoing studies and approvals in Europe. For women at extremely high risk of breast cancer, preventive mastectomy (surgery to remove the breasts) may be considered. While many breast cancers cannot be prevented, early detection and prompt treatment can save lives when breast cancer occurs.

Q: Is breast cancer inherited?

A:  All cancers involve changes in a person's genes. Usually, several changes are required before a cancer develops. If a person inherits a genetic mutation (change or defect), from a parent, they have a higher risk for developing cancer in their lifetime. It is currently believed that less than 10 percent of breast cancers involve an inherited genetic mutation. Most happen because of genetic mutations that occur during the person's lifetime. If a woman's mother, grandmother, aunts, or sisters developed breast cancer before menopause, she may have a greater chance of getting breast cancer than a woman with no family history. The same gene may increase risk for ovarian, prostate, and pancreatic cancers. Genetic testing may help determine if a woman has inherited a breast cancer gene.

Q: How often should I have a mammogram?

A: Experts have different recommendations for mammography. Currently, the U.S. Preventive Services Task Force recommends screening every two years for women ages 50 to 74. The American Cancer Society (ACS) recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them.

Q: Does it hurt to have a mammogram?

A: A mammogram may be slightly uncomfortable but it shouldn't hurt. In order to get a clear picture the breast is compressed between two flat plates. It lasts only a few seconds. It is a good idea to schedule a mammogram after your menstrual period when your breasts are less likely to be tender.

Q: Does breastfeeding either cause or prevent breast cancer?

A: Some studies have found that breastfeeding may reduce the risk of breast cancer. The benefit appears to be related to how long the woman breastfeeds. Studies that show benefit tend to be those in societies where a woman may have several children, breastfeed each for two years, with a total breastfeeding time approaching ten years. Studies that compare women who didn't breastfeed at all, to those who did for a few months, generally do not show a breast cancer reduction. However, the baby may certainly benefit from a few months of breastfeeding.

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On the day of your mammogram, it's important that you don't wear deodorant.