Breast Cancer: What is Your R... Video Transcript

Participants

, Seema A. Khan MD, Northweste Medical Faculty Fo , Gabrielle Morris MD

Summary

Breast cancer can strike any woman. But certain lifestyle choices and personal traits - including your genetic makeup - can affect your risk. What are the major factors, and how can you determine your risk? Join us as we talk to Seema Kahn, MD, of the Northwestern Medical School, for a detailed look at this important issue.

Webcast Transcript

VAREN BLACK:  I'm Varen Black, thanks for joining us and welcome to our webcast.

Breast cancer is a disease that can strike any woman.  But studies have shown that certain lifestyle factors and personal traits, including your genetic makeup, effect your risk.

Joining me today to talk about how doctors determine breast cancer risk is Dr. Seema Kahn, who is an Associate Professor of Surgery at Northwestern University Medical School.

VAREN BLACK:  Let's start with the basic risk factor, age, for instance.

SEEMA KAHN, MD:  Age is, in fact, the most important risk factor for breast cancer, and that applies across the world.  As women age, the risk of breast cancer increases.  It increases most sharply in the reproductive years from the age of approximately 30 onwards.  The rate of increase slows down around the menopause, but the increase in risk continues beyond the menopause.  In fact, about two-thirds of women, who are diagnosed with breast cancer, are over the age of 50.

Other risk factors really revolve around lifetime exposure to estrogen and possibly progesterone, which is the other hormone that comes from our ovaries.

Estrogen exposure begins at puberty and continues through each ovulatory cycle, each menstrual cycle until the time of menopause.  So one can sort of estimate that duration of estrogen exposure by looking at the age of puberty and the age at menopause.  Women who have early puberty and late menopause will have increased risk for breast cancer on that basis.

VAREN BLACK:  What other factors?  We mentioned genetic factors here.

SEEMA KAHN, MD:  Another aspect of estrogen exposure is also the age at first pregnancy.  Women who have their first child earlier will be protected somewhat against breast cancer.

VAREN BLACK:  Why is that?

SEEMA KAHN, MD:  Some of it is related to the interval between the onset of puberty and the time of the first pregnancy.  During the first pregnancy, the breast cells undergo what we call terminal differentiation, which means they prepare to make milk.  In that process of differentiation, they lose some of the ability to divide and develop genetic effects.

There are also hormonal changes that happen with the first pregnancy.  There is a hormone called prolactin which helps the breast make milk.  Prolactin levels, which may promote the causation of breast cancer, are permanently depressed after the first pregnancy.

VAREN BLACK:  What lifestyle factors?

SEEMA KAHN, MD:  In terms of breast cancer risk, women who are overweight after menopause are at increased risk for developed breast cancer.  Before the menopause, weight per se doesn't seem to make much of a difference, but regular physical exercise dose.  Women who exercise regularly four times a week or more will have a lower risk of breast cancer before the menopause.

Another risk is alcohol intake.  Women who drink regularly five to six times a week or greater have a significantly increased risk of developing breast cancer.  So it would be wise to restrict alcohol intake.

VAREN BLACK:  What options are available for women who are at increased risk for breast cancer, and what can they do to decrease the risk?

SEEMA KAHN, MD:  Women who are at increased risk for breast cancer can follow some of the advice that's given for general health maintenance.  Eat a varied diet, plenty of fruits and vegetables.