Breast cancer is the malignant tumor that most frequently affects women, showing an increase in its trend in recent years, possibly due to nutritional and reproductive changes.
Despite the increase in the number of cases, mortality from breast cancer has decreased in recent years thanks to the progressive advance of oncological treatments, a better knowledge of tumor biology and the introduction of screening programs, which allow early diagnosis of the disease and therefore allow the pathology to be dealt with in its initial stages. However, despite medical advances, breast cancer is the second leading cause of death in women, only behind lung cancer.
In Spain there is no national tumor registry system, but it is estimated that breast cancer cases are close to 25,000 cases per year, 29% of the total number of tumors diagnosed in women.
Risk factors for breast cancer
In breast tumors, around 90 to 95% of cases are sporadic cases, and only 5 to 10% of cases have an associated hereditary component.
But… Are there risk factors for developing breast cancer? Although the cause of this tumor is not clear, several risk factors that favor its development have been mentioned. Among them, some of the following can be found:
- Age
- Reproductive factors
- Endogenous sex hormones
- Life habits: diet, exercise, obesity…
- Genetic susceptibility
There are different genes that have been associated with a genetic predisposition, such as BRCA1 and BRCA2. The study of both is performed with a blood sample in these situations:
- Breast cancer diagnosed before the age of 35 years.
- Breast cancer diagnosed before the age of 40 if it is bilateral (affects both mammary glands) or the family history is not sufficiently informative
- Triple-negative subtype breast cancer before the age of 50 years
- Male breast cancer
- Cases of breast and/or ovarian cancer in different family members
Screening for breast cancer: helping to reduce mortality
The establishment of screening or population screening programs has helped to reduce breast cancer mortality, thanks to the fact that the disease can be diagnosed in early stages and/or phases.
The recommendation is:
- Perform a mammogram every two years for women between the ages of 50 and 74.
- Applying the screening program to women over 75 years of age may not be beneficial.
- Screening mammograms should not be performed on women between the ages of 40 and 49, but should be treated on a case-by-case basis.
- Current evidence is insufficient to perform complementary tests in women under 40 years of age.
The guidelines and recommendations to be followed among women aged 40-49 years have generated controversy. Thus, depending on the geographic area, different protocols may be followed, although the most frequent is to perform a mammogram every year once the age of 40 has been exceeded.
In turn, several studies support the idea that a mammogram and breast MRI every six months can be performed in women with an identified BRCA1 or BRCA2 mutation, as this can reduce the number of cases diagnosed in advanced stages.