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What Causes Breast Cancer and How Can I Decrease My Risk Of Developing It?

The world of cancer research is changing quickly but most scientists agree that the cause of breast cancer is multifactorial.  Breast cancer develops as a result of a combination of modifiable and non-modifiable risk factors.

Non-Modifiable Risk Factors for Breast Cancer

Non-modifiable risk factors include things that are mostly out of your control to change, depending on where you are in your life. They include:


Females are 100X more likely to develop breast cancer than males, however, men can develop breast cancer, too.

Age of Menarche

The age at which a woman begins her period may make a difference. The lower the age, the slight increase in your risk for potentially developing breast cancer.


Having children lowers risk.

Age of First Pregnancy

The lower the age of your first pregnancy, the lower the risk. Breastfeeding also lowers risk.

Current Age

Older age increases risk.

Age at Menopause

Going through menopause later age increases risk.

Mammographic Density

Increased breast tissue density increases risk (this is now required on mammogram reports).

Breast Biopsies

The more breast biopsies you have as well as a certain pathology on the biopsy report, may increase risk.


Ashkenazi Jewish/Eastern European Jewish heritage increases risk.

Family History

Incidence of breast and/or ovarian and some other cancers (pancreatic, colon, prostate) in first and second degree relatives (children, siblings, parents, grandparents, aunts and uncles), especially occurring in successive generations, increases risk.

It is important to know your family medical history so you can undergo risk assessment and possibly qualify for more aggressive screening protocols.

Genetic Mutations

Certain known genetic mutations in family members can increase risk.

Modifiable Risk Factors for Breast Cancer

Modifiable risk factors include things that you can actively work on to decrease your risk. These include:


Tobacco is a promotor for many cancers, including breast cancer. Quitting is the single best thing you can do for your health.


More than three alcoholic drinks per week may increase your risk for breast cancer.

Healthy Diet

A healthy diet that consists of: low sugar, low fat, low processed food, low preservatives/chemicals, less red meat, more fish, more fresh fruit and vegetables, may decrease the risk of many cancers. An example is the Mediterranean Diet.

Body Mass Index (BMI)

Maintaining a healthy weight decreases risk. A healthy goal for your BMI is 25.


A minimum of three hours of moderate exercise per week, even without weight loss, decreases risk.


Limiting oral contraceptive pills (OCPs) to 10 years, total, and using the least hormone replacement therapy (HRT) at menopause decreases risk. Fertility treatment does not increase risk.

Environmental Exposure(s)

Limit toxins and radiation exposure in the home and work.

  • Utilize personal protection equipment (PPE).
  • Have well water tested. Wash produce and consider buying “organic”.
  • Examine beauty products including permanent hair dye, cosmetics, etc.

Stress Reduction

Investigate and develop a regular program with meditation, yoga, and/or exercise. Seek out counseling and/or support groups, if needed.

Monthly Self Breast Exams

Self breast exams are best done at the end of menses, or the first of the month, if no menses. If a new mass doesn’t go away after 1 cycle or 1 month, schedule an appointment for evaluation. Many women find their tumors between scheduled screenings.

Annual Clinical Exams and 3D Mammograms

Annual clinical exams and/or 3D mammograms should be started for all women starting at 40 years of age (earlier, if high risk) without upper limit, if you are relatively healthy and able to undergo treatment.

It is much better to find and address a tumor when it is small, regardless of age. If mammograms are painful, schedule for the week after your period, and pre-medicate with over-the-counter Ibuprofen or Tylenol.

Maintain Appropriate Screenings

Continue annual checkups or well-woman exams, have vitamin D levels checked annually, and supplement, if indicated. Stay current on other cancer screening protocols – PAP and pelvic exams, skin checks and colonoscopies, as appropriate.

About Elissa Doty, PA

Elissa Doty is a nationally certified Surgery Physician Assistant at WakeMed Health & Hospitals. She completed a Bachelor’s degree at University of Virginia and worked in basic science and clinical research at Medical College of Virginia, University of California–San Francisco and Duke University before returning to study at Western Michigan University to become a PA.

While successful in her research career, she decided she wanted to care for patients directly and to empower them through patient education to take a more active role in their healthcare. Elissa completed the Intensive Course in Genetic Cancer Risk Assessment at City of Hope in 2019 and is currently working in the WakeMed General Surgery practice focusing on Breast Services.