• Age
  
• Exposure to exogenous estrogen
  
• Family history
  
• Pregnancy
  
• Genetics

• Age greater than 30 yrs

• 85% of breast cancers occur in women over 50yrs

• 10% in women in their 40’s

• 5% in younger women

• first degree relatives is most important

• number of affected family members-increased risk with closer the relation and earlier the age of diagnosis

• Prolonged exposure to endogenous estrogen.

• Look at early onset of menarche-age <12yrs

• Late menopause age>55yrs

• Pregnancy- first life birth before 30yrs

• Risk increases for live births after 35yrs

• Risk again increases for nulliparous women

• Also there is an increased risk with lower cumulative months of lactation

• All of these prolong lifetime exposure to estrogen peaks of menstrual cycle

• After menopause –initiation of estrogen replacement therapy ( ERT)

• Delays onset of osteoporosis

• Protective against heart disease and stroke

• Studies have shown an increased risk of breast cancer after 5yrs

• Consensus that benefits outweigh risks

Category: Surgery MCQs