Breast cancer remains a significant health concern, particularly for older women, whose risk of developing the disease increases with age. While some risk factors, such as genetic predispositions and hormonal changes, are beyond control, there are many modifiable factors that can influence the likelihood of breast cancer. By focussing on lifestyle changes, routine screenings, and careful management of hormone therapy, older women can take proactive steps to reduce their risk and enhance their overall well-being.
Dr Rohan Khandelwal, Lead Consultant and Head of the Breast Centre at CK Birla Hospital, Gurugram, emphasises the importance of addressing both non-modifiable and modifiable risk factors to effectively manage and lower breast cancer risk in elderly women.
Non-modifiable risk factors
Certain risk factors for breast cancer are intrinsic and cannot be altered. Ageing is the most significant non-modifiable risk factor, with women over the age of 60 facing a markedly higher risk of breast cancer compared to younger women. As cells undergo changes with age, the likelihood of malignant cell growth increases.
Early menarche and late menopause: Women who experience their first menstrual period before age 12 or enter menopause after age 55 are exposed to oestrogen for longer periods. This extended exposure to oestrogen can increase the risk of developing breast cancer.
Dense breast tissue: Women with dense breast tissue, characterised by more glandular and less fatty tissue, face a higher risk of breast cancer. Dense tissue can also make it more challenging to detect tumours through routine screenings.
Genetic predispositions: Genetic mutations, particularly in the BRCA1 and BRCA2 genes, significantly elevate breast cancer risk. A family history of breast cancer further compounds this risk, making genetic screening an important consideration for women with such histories.
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Modifiable risk factors
While some risk factors are unchangeable, several modifiable factors can significantly reduce breast cancer risk. Addressing these factors can lower the incidence of breast cancer by 25–30 per cent.
Obesity: Excess body weight increases oestrogen levels, which can accelerate the development of certain types of breast cancer, particularly in postmenopausal women. Maintaining a healthy weight through a balanced diet and regular exercise is a key preventive measure.
Alcohol consumption: Excessive alcohol intake is linked to higher breast cancer risk due to its effects on cell DNA and oestrogen levels. Reducing alcohol consumption or abstaining altogether can decrease this risk.
Smoking: Smoking is a well-known risk factor for various cancers, including breast cancer. Quitting smoking can significantly lower the risk of developing the disease.
Other risk factors
Additional factors that can influence breast cancer risk include:
Nulliparity and late childbirth: Women who have never given birth or who have their first child after age 30 are at increased risk due to prolonged oestrogen exposure.
Hormone Replacement Therapy (HRT): Long-term use of HRT can increase breast cancer risk. It is important for women undergoing HRT to discuss the risks and benefits with their healthcare providers.
Breastfeeding: On a positive note, breastfeeding for more than a year can reduce breast cancer risk slightly by lowering oestrogen levels in the body.
Can breast cancer be prevented?
While there is no guaranteed way to prevent breast cancer, managing modifiable risk factors can substantially lower the likelihood of developing the disease. Adopting a healthy lifestyle—maintaining a healthy weight, reducing alcohol intake, quitting smoking, and engaging in regular physical activity—can make a significant difference. Women with a family history of breast cancer should consider genetic testing and counselling to better understand their risks.
Routine screenings, such as mammograms, are essential for early detection, particularly in older women. Early identification improves survival rates and treatment outcomes.
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