Breast Cancer Awareness

Breast cancer develops when cells in the breast tissue begin to grow and divide abnormally and uncontrollably, to form a growth or tumour. It is the most commonly diagnosed cancer among women worldwide, accounting for approximately 1 in 4 of all female cancer cases. In the MENA region, breast cancer represents around 1 in 3 of all cancers diagnosed in women.

Only 5-10% of breast cancers are hereditary; in contrast, nearly 25% of breast cancers are preventable by adopting lifestyle measures.

 

What are the risk factors for breast cancer?

Risk factors include those which you cannot control, for example gender or age and those you can control, such as diet and physical activity.

Risk factors you cannot or may not be able to control

  • Gender and age are the strongest risk factors for breast cancer.

    • Being born female – 99% of breast cancers occur in women – it is important to note that men also have breast tissue and breast cancer in men accounts for 0.5-1% of all breast cancer diagnosis.
    • Age – breast cancer becomes more common with increasing age, especially after the age of 40, with the likelihood increasing as we get older. 
  • Hereditary – genetic risk only accounts for 5-10% of all breast cancer cases.  The most common genetic mutations linked to breast cancer are BRCA 1 or BRCA 2, which also carry an increased risk of ovarian cancer.
    • Knowing your family history of cancer is important to assess risk.  Having one first-degree relative with breast cancer doubles your risk, and having two first-degree relatives triples your risk. 
    • Personal history of breast cancer – having a history of breast cancer in the past increases the risk of developing cancer in another part of the same breast or in the other breast.
  • Radiation therapy to the chest – women previously treated with radiation therapy to the chest for another cancer when younger have an increased risk for breast cancer.  The risk is highest when radiation is given when the breasts are still developing, in teenagers and young adults.
  • Starting menstrual periods early and/or having a late menopause – women who started menstruating early, especially before the age of 12, have a slightly higher risk of breast cancer, as do women who have a late menopause, usually after the age of 55 years.  This risk is due to the increased exposure to hormones from an increased number of menstrual cycles through their lifetime.
  • Older age for first pregnancy – women who have their first pregnancy after the age of 35 years or who never become pregnant have an increased risk of breast cancer compared to women who have their first baby at an earlier age and have multiple pregnancies. 

Which lifestyle factors have been shown to reduce the risk of breast cancer?

There are several lifestyle related risk factors that can be controlled including diet, physical activity, maintaining a healthy weight, alcohol avoidance and smoking cessation.

  • Nutrition

    • Fruits and vegetables have been shown to decrease the risk of breast cancer by about 10%.  Aim to include at least five portions of fruit and vegetables each day and try to vary your choices throughout the week to get a wide range of nutrients and antioxidants.
    • Here are some great options to include as part of a balanced diet:
      • Carotenoids - yellow/orange fruits and vegetables, such as butternut squash, carrots, bell peppers, tomatoes and apricots
      • Green leafy vegetables, like spinach, bok choy, collard greens and rocket.
      • Cruciferous vegetables, such as kale, cabbage, broccoli and cauliflower
      • Berries including blueberries, raspberries and blackberries
      • A variety of herbs and spices – curcumin in particular, in the form of turmeric has been shown to have anti-cancer properties.
    • A diet high in fibre – in addition to a variety of fruits and vegetables, include wholegrains, legumes, nuts and seeds.

    • Limit consumption of saturated fat – some studies have shown a positive link between saturated fat intake and breast cancer risk.  Processed and red meats, have been linked to an increased risk of cancer, including breast cancer. 
    • Avoid ultra-processed foods such as crisps or biscuits, soda drinks and “fast foods”.  One study showed a 10% increase in the proportion of ultra-processed foods in the diet resulted in a 10% increased risk of overall and breast cancer.
    • Including soya in the diet may help reduce the risk of breast cancer. Rates of breast cancer are lower in Asian countries, where soya consumption is much higher than in Western populations. One study even showed that swapping dairy milk for soya milk could reduce breast cancer risk by up to 32%. To get the most benefit, choose whole or minimally processed soya foods such as edamame beans, tempeh, tofu, soya yoghurt, and unsweetened soya milk. (Note: If you’re taking thyroxine for hypothyroidism, it’s important to leave a gap of at least four hours between your medication and consuming soya-based foods, as soya can interfere with absorption).

After the diagnosis of breast cancer, adopting a low-fat diet with the inclusion of fruits, vegetables and wholegrains has shown to reduce death from breast cancer by up to 21%.

  • Incorporate physical activity - regular physical activity reduces breast cancer risk by up to 21% compared to women with low activity levels - greater levels of activity confer a greater degree of protection.  Aim to incorporate about 30 minutes of moderate intensity activity (such as brisk walking) five times a week. 
    After a diagnosis of cancer, incorporating regular physical activity can reduce the risk of death by nearly 40%.
  • Maintain a healthy weight – research shows women who are carrying excess weight after the menopause have higher risk of breast cancer compared to women who are in the normal weight range.  Although weight management is influenced by multiple factors, a diet high in fibre that is predominantly plant-based, low in saturated fat and processed foods, alongside regular physical activity, will help with weight management.
  • Avoid alcohol – the link between alcohol and breast cancer is very strong.  Drinking three to six drinks per week increases the risk of breast cancer by 15% compared to women who do not drink.  There is no safe limit when it comes to alcohol and cancer – the less you drink, the more you lower your risk.
  • Quit smoking - tobacco contains many cancer-causing chemicals.  If you smoke, it is best to quit and not replace it with any other form of tobacco.  All forms of tobacco are harmful.  
  • For mothers, breastfeed if possible – breastfeeding has shown to reduce the risk of breast cancer.

Symptoms and signs of breast cancer

  • A lump in the breast, chest or armpit or any thickening or puckering of the skin in those areas.
  • Dimpling, redness or pitting of the skin of the breast – it might look a bit like the skin of an orange.
  • Changes in the appearance of your nipple – such as flattening, turning inward or pointing in a different direction. 
  • Scaling, peeling or flaking of the skin around your nipple or anywhere on the breast. 
  • Discharge from the nipple especially if you are not pregnant or breastfeeding.
  • Any change in size, shape, appearance or feel of your breast.
Please note, most lumps that are found are usually not cancerous; however please see your doctor if you find a breast lump or any changes described above for further evaluation, even if you have recently had a mammogram. 
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Screening recommendations

Breast cancer is curable if diagnosed early and the purpose of regular screening is to detect breast cancer at an early stage. 

It is recommended that women aged 40 to 69 undergo a screening mammogram every two years. The starting age for screening may vary by region - check local guidelines or speak with your doctor. 

Women at increased risk of breast cancer may be advised to start screening at an earlier age.  (This includes those with a previous history of breast or ovarian cancer, previous treatment with chest radiation under the age of 30 years, previous abnormal breast biopsy, a strong family history or increased genetic risk).

Regular breast self-examination is recommended for all women from the age of 20, looking for any changes described above.  In pre-menopausal women, the best time to examine your breasts is a few days after your menstrual cycle ends, when they are least swollen and tender.  In post-menopausal women, identify a regular date every month to perform your self-examination. 

While self-examination is a helpful practice, it should not replace regular screening mammograms and clinical examination by your healthcare professional.

Disclaimer:
The content in this article is for general informational purpose and is not meant to replace or substitute for professional medical advice, diagnosis or treatment.  Always consult a qualified healthcare professional with any questions or concerns about your health.

References :

  • Global Cancer Observatory (who.int)
  • Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024; 74(3): 229-263.
  • The National Guideline For Breast Cancer Screening and Diagnosis | Ministry of Health and Prevention - UAE
  • https://www.cancer.org/cancer/types/breast-cancer
  • Farvid MS, Chen WY, Rosner BA, Tamimi RM, Willett WC, Eliassen AH. Fruit and vegetable consumption and breast cancer incidence: Repeated measures over 30 years of follow-up. Int J Cancer. 2019;144(7):1496-1510.
  • Gary E Fraser, Karen Jaceldo-Siegl, Michael Orlich, Andrew Mashchak, Rawiwan Sirirat, Synnove Knutsen, Dairy, soy, and risk of breast cancer: those confounded milks, International Journal of Epidemiology, Volume 49, Issue 5, October 2020, Pages 1526–1537
  • Rowan T. Chlebowski et al., Dietary Modification and Breast Cancer Mortality: Long-Term Follow-Up of the Women’s Health Initiative Randomized Trial. JCO 38, 1419-1428(2020).
  • Dietary Modification and Breast Cancer Mortality: Long-Term Follow-Up of the Women’s Health Initiative Randomized Trial. JCO 38, 1419-1428(2020).
  • Lynch BM, Neilson HK, Friedenreich CM. Physical activity and breast cancer prevention. Recent Results Cancer Res. 2011;186:13-42.
  • Breasts The Owner’s Manual, Dr Kristi Funk
  • Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC. Moderate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk. JAMA. 2011;306(17):1884–1890.
  • 12-NEW-BMS-ToolsforClinicians-Fast-Facts-HRT-and-Beast-Cancer-Risk-SEPT2025-B.pdf