An update (2019) on breast cancer risk factors and the ways to reduce the risk. Breast awareness campaign for October Breast Cancer Awareness month 2019 at Al Hammadi Hospital, Nuzha, Riyadh, KSA. شهر اكتوبر تشرين الاول من كل عام هو شهر التعريف عن سرطان الثدي العالمي مستشفى الحمادي النزهة في الرياض المملكة العربية السعودية تقوم سنويا بهذا الشهر بالتوعية بالمرض لخدمة مرضاها و عوائلهم نحن بعون الله نرعاكم

1. BREAST CANCER
RISK FACTORS
‫الثدي‬ ‫بسرطان‬ ‫االصابة‬ ‫خطر‬ ‫عوامل‬
DR MOHAMAD AL-GAILANI FRCS
‫الكيالني‬ ‫محمد‬ ‫الدكتور‬
CONSULTANT BREAST & GENERAL SURGEON
CHIEF OF SURGERY
OCTOBER
2019
AL HAMMADI HOSPITAL, NUZHA ‫الحمادي‬ ‫مستشفى‬,‫النزهة‬
RIYADH, ‫الرياض‬

2. BREAST CANCER RISK FACTORS
OUTLINE
 OVERVIEW OF BREAST CANCER
 RISK FACTORS YOU CAN’T CONTROL
 RISK FACTORS YOU CAN CONTROL
 HOW TO DECREASE BREAST CANCER RISK?
 ‫الخالصة‬
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 2

3. OVERVIEW OF
BREAST CANCER
 Globally is the most frequently diagnosed cancer in women, over 2
million new cases in 2018.
 Leading cause of cancer death in women, particularly in women aged 40
to 49.
 In Saudi Arabia in recent years, there is a substantial rise in the incidence
of breast cancer & in a younger age group.
 The incidence however is still below the global average.
 Many cases still present late as compared to the Western World.
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 3

4. WORLD BREAST CANCER
RATES RANKING
(RATE: PER 100,000)
 1st: Belgium 113.2
 4th: France 99.1
 6th: Lebanon 97.6 (1st among Arab countries)
 8th: UK 93.6
 22nd: US 84.9
 *REFERENCE: WORLD CANCER RESEARCH FUND INTERNATIONAL 2018
 KSA 24.3
 *REFERENCE: CANCER INCIDENCE REPORT SAUDI ARABIA 2015
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 4

5. RISK FACTORS
YOU CAN’T CONTROL
1. Gender: Being a woman is the most significant risk factor for
developing breast cancer.
2. Age: The second biggest risk factor for breast cancer.
 Age 30 to 39 the risk is 1 in 228 (0.44%)
 Age 40 is 1 in 29 (3.5%)
 Age 80 is 1 in 8 (12%)
3. Race: The highest risk is in White women followed by African
American, Asian, Hispanic and Native American.
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 5

6. 4. Family history of breast cancer: However only 5-10% of breast cancers
are familial (genetic)
5. Personal history of breast cancer: If you have already been diagnosed
with breast cancer, your risk of developing it again is higher
6. Radiation therapy to the chest: Especially as a child or young adult as
treatment for other cancers e.g. Lymphoma
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 6
RISK FACTORS
YOU CAN’T CONTROL

7. 7. Breast cellular changes: Unusual changes in breast cells found during a
breast biopsy can be a risk factor for developing breast cancer like
Atypia or Lobular Carcinoma In Situ (LCIS).
8. Duration of Exposure to Oestrogen:
 Menarche before age 12
 Menopause after age 55
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 7
RISK FACTORS
YOU CAN’T CONTROL

8. OTHER INDEPENDENT
RISK FACTORS
 Never having a full-term pregnancy: risk
 Having the first full-term pregnancy after age 30: risk
 Pregnancy: risk (reduces the overall number of menstrual cycles in a
woman’s lifetime)
 Breastfeeding for 1 to 2 years: risk
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 8

9. RISK FACTORS
YOU CAN CONTROL
1. Obesity: Having a BMI ((Weight (Kg)/Height (M2))) over 30
2. Diet: The Women's Health Initiative Trial suggested that a diet very low
in fat may reduce the risk of breast cancer.
3. Exercise: The American Cancer Society recommends engaging in 45-60
minutes of physical exercise 5 or more days a week.
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 9

10. 4. Alcohol: Alcohol can limit the liver’s ability to control blood levels of the
hormone oestrogen.
5. Smoking: associated with a small increase in breast cancer risk.
6. Hormone Replacement Therapy (HRT): taking combined hormone HRT for
over 10 years
7. Oral Contraceptive Pill (OCP): slightly increase risk but only for a limited period
of time. Women who stopped using OCP more than 10 years before do not
appear to have any increased breast cancer risk.
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 10
RISK FACTORS
YOU CAN CONTROL

11. FACTORS WITH
NO CLEAR PROOF
 Stress and Anxiety: There is no clear proof that stress
and anxiety can increase breast cancer risk.
 Prayer, meditation & yoga may according to some
research can strengthen the immune system.
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 11

12. MYTHS OR
FACTORS NOT PROVEN TO BE
RELATED TO BREAST CANCER
 Fibrocystic breast changes
 Multiple pregnancies
 Coffee or caffeine intake
 Use of anti-perspirants
 Wearing underwire bras
 Using hair dye
 Having an abortion or
miscarriage
 Breast implants
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 12

13. HOW TO DECREASE
BREAST CANCER RISK?
1. Avoid alcohol
2. Don't smoke
3. Control your weight
4. Be physically active
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 13

14. HOW TO DECREASE
BREAST CANCER RISK?
5. Breast feed:
6. Limit duration of HRT:
7. Risk Assessment Consultation: If breast cancer runs in your family for
advice & possible BRCA 1 & BRCA 2 gene testing
8. Chemoprevention: Tamoxifen, Raloxifene
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 14

15. CONCLUSION
 Breast cancer remains the number one of all cancers affecting women
globally
 The main risk factors are age, alcohol, obesity, family history, HRT & lack
of exercise
 Important factors in preventing breast cancer include avoiding alcohol,
not being obese, exercising and limiting HRT use.
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16. ‫الخالصة‬
‫المرأة‬ ‫تصيب‬ ‫التي‬ ‫السرطان‬ ‫أنواع‬ ‫جميع‬ ‫بين‬ ‫من‬ ‫األول‬ ‫هو‬ ‫الثدي‬ ‫سرطان‬ ‫يزال‬ ‫ال‬
‫العالمي‬ ‫الصعيد‬ ‫علي‬
،‫السمنة‬ ،‫الكحول‬ ،‫العمر‬ ‫هي‬ ‫الثدي‬ ‫بسرطان‬ ‫لإلصابة‬ ‫الرئيسية‬ ‫الخطر‬ ‫عوامل‬
‫ممارس‬ ‫عدم‬ ‫و‬ ‫التعويضية‬ ‫الهورمونات‬ ‫استخدام‬ ‫في‬ ‫االفراط‬ ،‫العائلي‬ ‫االستعداد‬‫ه‬
‫الرياضة‬
‫تجنب‬ ،‫الكحول‬ ‫تجنب‬ ‫تشمل‬ ‫الثدي‬ ‫بسرطان‬ ‫االصابة‬ ‫خطر‬ ‫من‬ ‫للحد‬ ‫هامه‬ ‫عوامل‬
‫التعويضية‬ ‫الهورمونات‬ ‫استخدام‬ ‫افراط‬ ‫من‬ ‫والحد‬ ‫الرياضة‬ ‫ممارسه‬ ،‫السمنة‬
BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 16

17. BREAST CANCER RISK FACTORS OCTOBER BREAST CANCER AWARENESS MONTH 2019 17