Most breast cancers occur in women with no family history

Illustration by Getty Images International.

Illustration by Getty Images International.

Women at increased risk for developing breast cancer have a growing number of options to help prevent the disease — but you may be surprised to learn who is at high risk.

Angelina Jolie garnered media attention in May 2013 when she underwent a preventive double mastectomy, revealing a family history of breast cancer and a faulty genetic mutation.

“It’s important to keep that in perspective,” says Jayne Charlamb, MD, who directs Upstate’s Breast Cancer High Risk Program. “The vast majority of women who get breast cancer have absolutely no family history.” She says only about 5 to 10 percent of breast cancers are thought to be hereditary, caused by abnormal genes passed from one generation to the next.

Women with a mutation in the same gene as Jolie’s, known as BRCA, are at increased risk — but so are many others.

As a woman ages, her risk increases. Not having children, or having children later in life puts a woman at higher risk than one who bears children when she is young. “Not breastfeeding puts you at a higher risk,” says Charlamb. Also, a woman with dense breast tissue has an increased risk of developing breast cancer.

Some women with a BRCA mutation are opting to have their breasts removed, like Jolie, to reduce their risk of developing breast cancer.

Others at high risk for the disease are choosing “chemoprevention,” a 5-year course of medications that reduces risk by about 50 percent during, and sometimes beyond, those five years, Charlamb says. The medications include selective estrogen receptor modifiers, which block the effects of estrogen on breast tissue, and aromatase inhibitors, which stop a key enzyme from changing other hormones into estrogen.

In addition, Charlamb and other breast cancer experts are studying the promise of vitamin D for breast cancer prevention, especially in women with dense breast tissue.

Prevention remains important, especially for women with an increased risk. Charlamb tells her patients to exercise regularly and to eat a diet rich with fruits and vegetables that includes a variety of foods and avoids processed foods and red meats. She also discusses alcohol intake.

“There is pretty clear evidence now that even very moderate alcohol intake — one drink a day — is enough to significantly increase a woman’s risk of developing breast cancer,” the doctor says.

Though it’s impossible to entirely eliminate breast cancer risk in any woman, a healthy lifestyle can bring down a woman’s risk of developing breast cancer, even if that woman is at very high risk due to a genetic mutation.

Women interested in the Breast Cancer High Risk Program can call 315-464-8224 to schedule an appointment.

Hear an interview with Charlamb about the Breast Cancer High Risk Program

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