Breast cancer is a malignant neoplasm in the breast. Breast cancers are classified as noninvasive (in situ) or invasive (infiltrating) with approximately 70% of all breast cancers possessing a component of invasion.
Only 20% of patients have a significant family history of breast cancer. This predisposition tends to be autosomal dominant with maternal lineage.
Recent studies have revealed families with breast cancer susceptibility genes including BRCA1 and BRCA2.
Family history suggestive of breast cancer susceptibility genes include multiple first and second degree relatives with early breast cancer diagnosis and the presence of ovarian cancer. Approximately 1 in 400 U.S. women will carry a germ-line mutation for BRCA1. BRCA1 carriers have approximately an 85% chance of developing breast cancer in a lifetime. BRCA2 carriers have a higher risk of male breast cancer.
The specific cause of breast cancer is unknown.
Increased breast cancer risk occurs in first degree relatives (relative risk [RR] = 2.3), with bilateral disease in premenopausal relatives (RR = 10.5), or bilateral disease in postmenopausal relatives 5.0)
Increased hormone risks include early menarche, late menopause, nulliparity or first full term pregnancy after age 30
Women with a prior history of breast cancer or previous breast biopsies revealing atypical changes increased risk (5-10 times) for subsequent cancer
Inconclusive risk factors include exogenous estrogen use, high dietary fat, or high alcohol use
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