Dr. Sabeena Choudhary, MD, DM.
Everyone has some risk of developing breast cancer. Yours may be higher or lower, depending on gene, environment or lifestyle.
Know Your Risk for Breast Cancer.
Breast cancer is the most common cancer in women worldwide. In many Western countries, roughly 1 in 8 women (about 13%) will develop it at some point in her life. That sounds daunting — but here’s the encouraging part: about half of all breast cancers can be traced to risk factors we already understand, and several of them are within your control.
This is a quick guide to what actually raises risk, what lowers it, what doesn’t matter despite the rumours, and what to do about it.
Things You Can’t Change:
Age. This is the biggest factor. Risk climbs steadily with each decade, and most breast cancers occur after menopause.
Being a woman. Breast cancer is about 100 times more common in women than men — though men can get it too.
Family history. One close relative (mother, sister, and daughter) with breast cancer roughly doubles your risk; two can triple it. Risk is higher if a relative was diagnosed young.
Inherited genes. Only about 5–10% of breast cancers come from a single inherited gene fault, most often in the BRCA1 or BRCA2 genes. Women who inherit one of these can have a lifetime risk as high as around 70%, versus about 13% for the average woman. (More on testing below.)
Dense breasts and past biopsies. “Dense” breast tissue (seen on a mammogram) both raises risk slightly and makes tumours harder to spot. Certain past biopsy findings — such as atypical hyperplasia or lobular carcinoma in situ (LCIS) — signal higher-than-average risk and usually mean closer monitoring.
Height. Taller women have a modestly higher risk — likely tied to childhood growth and hormones.
Your Hormones and Reproductive Life:
Because most breast cancers are fuelled by the hormone estrogen, anything that changes your lifetime estrogen exposure nudges risk up or down. Here are some pointers that may help you identify factors that tend to raise or lower the risk for developing breast cancer.
Tends to RAISE risk
Periods starting early / menopause arriving late
Never having children, or first child after 35
Combined estrogen + progestin menopausal hormone therapy
Current combined birth-control pills (fades within a few years of stopping)
Tends to LOWER risk
Breastfeeding (more months = more benefit)
Having your first child before 30
Estrogen-only hormone therapy (only for women without a uterus)
Regular physical activity
Worth knowing: with menopausal hormone therapy, the progestin component seems to carry most of the added risk. Estrogen alone (an option only after a hysterectomy) does not raise risk and may even lower it. This is a conversation to have with your doctor rather than a blanket rule.
What You Can Influence:
Alcohol. One of the clearest links there is. Risk rises even at low intake — around one drink a day adds roughly 5–10% — and climbs with more. Less alcohol means lower risk.
Weight (and a surprising twist). After menopause, carrying extra weight raises risk, and losing weight lowers it. Before menopause, the pattern flips — a higher weight is linked to slightly lower risk. Either way, staying active and healthy is the safe bet, especially in midlife and beyond.
Exercise. Regular activity lowers risk — you don’t need to be an athlete; moderate, consistent movement counts.
Smoking. Both smoking and heavy secondhand smoke exposure modestly raise risk.
Diet. No single food is magic, but a pattern rich in vegetables, fruit, whole grains and fibre — and lower in fat and processed meat — is linked to better outcomes.
Myths You Can Let Go Of
There are myths surrounding breast cancer. Extensive research shows these do NOT meaningfully raise breast cancer risk: abortion (whether induced or a miscarriage); caffeine (coffee, tea, cola); breast implants, hair dyes, antiperspirants; electric blankets and everyday electronics; IVF (fertility treatment); antioxidant vitamin pills; “tubes tied” (tubal ligation).
Should You Consider Genetic Testing?
Most breast cancer is not inherited. But a strong family pattern can point to a gene fault worth checking. Consider asking your doctor about genetic counselling if you or a close relative has had:
(a) Breast cancer before age 50, or breast cancer in a man.
(b) Triple-negative breast cancer, or cancer in both breasts.
(c) Ovarian, pancreatic, or aggressive prostate cancer.
(d) Several relatives on the same side of the family with these cancers.
(e) Ashkenazi Jewish ancestry (certain gene faults are far more common — about 1 in 40 people, versus roughly 1 in 400 in the general population).
A positive result is not a diagnosis — it means your risk is higher, and there are proven ways to manage it: extra screening, risk-lowering medication, and, for the highest-risk women, preventive surgery. A result of “uncertain significance” is common and is not treated as positive; your care is guided by your personal and family history.
The Bottom Line — Five Practical Steps:
(i) Know your family history and share it with your doctor.
(ii) Screen on schedule. Ask when to start mammograms and whether you need to start earlier or add an MRI because of higher risk.
iii) Go easy on alcohol — the most clear-cut factor you can act on.
(iv) Stay active and keep a healthy weight, particularly after menopause.
(v) Don’t smoke, and breastfeed if you can and choose to.
You can’t change your genes or your age. But between screening, lifestyle, and — for some women — genetic counselling, you have real influence over your breast cancer risk.
Note: This article is for general education and is not a substitute for personal medical advice. Every woman’s risk is different — talk with your doctor about the screening and prevention plan that’s right for you.
Author:
Dr. Sabeena Choudhary, MD, DM.
DM Medical Oncology (Gold Medalist),
Kidwai Memorial Institute of Oncology, Bengaluru.
Rajiv Gandhi University of Health Sciences (RGUHS), Bengaluru, Karnataka, India.
Consultant Medical Oncologist at Rajiv Gandhi Cancer Institute & Research Centre (RGCI), New Delhi, India
References:
Bhardwaj PV, Dulala R, Rajappa S, Loke C. Breast Cancer in India: Screening, Detection, and Management. Hematol Oncol Clin North Am. 2024 Feb;38(1):123-135. doi: 10.1016/j.hoc.2023.05.014. Epub 2023 Jun 15. PMID: 37330342.
Pal A, Taneja N, Malhotra N, Shankar R, Chawla B, Awasthi AA, Janardhanan R. Knowledge, attitude, and practice towards breast cancer and its screening among women in India: A systematic review. J Cancer Res Ther. 2021 Oct-Dec;17(6):1314-1321. doi: 10.4103/jcrt.JCRT_922_20. PMID: 34916359.