definition

Breast cancer is the malignant growth of tissue in the breast, which is one of the most common malignant diseases in women. In rare cases, it also occurs in male patients. Breast cancer can be new as a result of mutations or it can be predisposed to a hereditary component. The disease can arise from different types of tissue in the breast and is divided into different stages. The most common origin here is the degeneration of mammary gland tissue and the degeneration of milk duct tissue. In advanced stages, the cancer can spread to other parts of the body, which worsens the patient's prognosis and can also be fatal.

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What are the causes and risk factors?

In general, the majority of cancer types in breast tissue can be divided into two categories:

  • Degeneration from the mammary gland tissue

  • Degeneration starting from the milk duct tissue

Causes and risk factors in the development of breast cancer cannot be precisely differentiated from one another, since not every person exposed to the risk factor will develop breast cancer, but these cannot be ruled out as causes for such a disease, as they increase the risk of it:

  • BRCA1 / BRCA2 or other inherited mutations

  • Spontaneous mutations in breast tissue

  • Alcohol consumption

  • Smoke

  • Use of artificial hormones

  • Mastopathy grade II and grade III

What is the breast cancer gene?

One gene mutation that is very often associated with the development of breast cancer is the mutation on Breast Cancer Gen 1 or 2 (BRCA1 / BRCA2). If these genes function normally, uncontrolled cell growth in the body is inhibited, which normally protects against developing breast cancer. In patients with a mutation of these genes, the protective component of the gene is lost, so that the body cannot compensate for incorrect processes as well. Mutations of the BRCA1 or BRCA2 gene can be detected in up to 10% of carcinomas in the breast. Since these are inherited dominantly, the risk of passing the mutation on to offspring is high. Patients who are carriers of such a mutation have a multiple higher risk of developing breast cancer. In addition, the disease also occurs in many cases at a much younger age than in patients without a family history. At the same time, both the BRCA1 and the BRCA2 mutation are associated with the occurrence of ovarian cancer.

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More about this on our website Tumor markers in breast cancer

How often is breast cancer inherited?

In most cases, women with breast cancer do not have any inherited components. The proportion of breast cancer cases due to the BRCA1 or BRCA2 mutation is up to every 10th woman with breast cancer. Since men get sick much less often, the data situation here is uncertain. However, it should not be ignored that BRCA mutations are not the only causes of hereditary breast cancer cases in the family, since other gene mutations can also increase the risk of the individual breast cancer risk.

How high the individual risk is for a person must be assessed by your doctor, especially taking into account the family history. If several family members have breast or ovarian cancer, or if one of these cancers occurred in a family member at a young age, it is advisable to ask a doctor about their individual risk. Since the BRCA mutations are inherited dominantly, the risk of being a carrier in one affected parent is up to 50% for the offspring if the other parent is not affected by the mutation. Anyone who belongs to the risk group should have a genetic test done in order to better assess their own risk.

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Are there psychological or emotional causes?

In the discussion about the genesis of cancer, the question arises again and again whether psychological or emotional stress could be the cause of the malignant degeneration of cells. Some even believe that certain personality traits could be cancer-promoting. This type of cancer cause leaves room for speculation, but the scientific evidence of such theories is problematic and has not yet been reliably clarified. There may be a connection between certain psychological processes, which in turn lead to a feeling of stress in the person concerned, but whether this has an effect on the risk of cancer has not been proven with certainty.

Typical risk factors for breast cancer

Smoke

The risk factors include the consumption of cigarettes and other tobacco-containing stimulants. Not only is this a risk factor for certain lung diseases and countless types of cancer, the genesis of breast cancer can also be significantly increased by smoking. The length of time and age at which tobacco consumption began play an important role. Exactly how smoking promotes the development of cancer is the subject of current research.

alcohol

Excessive alcohol consumption can promote the development of breast cancer and is therefore a risk factor. Of course, this does not apply to the smallest amounts of alcohol, because the risk only increases with heavy or pathological consumption.

Protective factors for breast cancer

In addition to many factors that can promote the development of breast cancer, there are also protective factors. In addition to a healthy lifestyle such as abstinence from alcohol and cigarettes, this also includes, above all, reducing body fat to a healthy proportion through diet and exercise. Pregnancies are also among the factors protecting against breast cancer, as the complete development of the mammary gland tissue is supported during this time and the likelihood of degeneration in old age is reduced. The number of pregnancies plays a role here, as multiple pregnancies reduce the risk more drastically. In addition, breastfeeding seems to have a protective effect against breast cancer.

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What role does taking the pill play?

The use of hormonal contraceptives is widespread and is considered one of the safest methods of contraception. There is research into whether taking it increases the risk of breast cancer in women. At the moment, however, there are no studies that conclusively prove this, so the intake, if it has been agreed with the gynecologist, is usually not to be considered dangerous.

What role does stress play?

Whether or how a stressful life situation is involved in the development of breast cancer or whether people with a lot of stress at work or in everyday life are more likely to develop breast cancer has not been conclusively clarified. It is generally assumed, however, that psychological stress and the associated lifestyle changes, such as unhealthy eating, little physical exercise, consumption of luxury foods and similar changes in habits, could have an effect on the performance of the body's repair system. This impairment could hinder the fight against degenerate cells, which would be conducive to the development of cancer.

What role does diabetes mellitus play?

Diabetes mellitus, popularly referred to as “diabetes”, appears to have a negative effect on the chances of recovery for patients with breast cancer. In retrospect, studies found a higher mortality rate in patients with diabetes mellitus and breast cancer than in patients without diabetes mellitus and breast cancer. This may be due to the limitation of therapy options due to the underlying disease. In addition, the insulin initially present in high quantities in type 2 diabetes mellitus patients has a positive effect on tumor growth.

What is the role of obesity?

Too much adipose tissue can also be a risk, as the precursor levels of estrogen are converted into this in the fat cells, and therefore a higher level of the hormones that promote breast cancer may be present in obese patients.

What is the role of dense breast tissue?

Dense breast tissue occurs in young women in the reproductive phase, as this is where the glandular bodies in the breast have a larger proportion. But women after the last period can also have very dense glandular tissue. In general, breast tissue can be divided according to its density, whereby a very dense breast tissue harbors a higher risk of degeneration because, among other things, screening methods such as mammography are more unreliable than in patients with less dense breast tissue.

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What is the role of the onset and absence of menstrual periods?

The medically proven risk factors for the development of breast cancer include hormonal influences, among other factors. A very long hormonally active period, for example due to an early start of the period and a late last rule, are particularly beneficial factors. This is mainly due to the fact that in patients with a long hormonally active phase of life, the sex hormones act on the breast tissue for a long time and can thus stimulate tissue growth over a long period of time. Likewise, certain hormone replacement therapies in the phase of life after the last period are seen as favoring breast cancer.

What role do other types of cancer play in the development of breast cancer?

Patients who have already had one type of cancer are more likely to develop breast cancer as well. This is especially true for certain types of cancer. In addition to the presence of breast cancer in just one breast, this also includes colon cancer, ovarian cancer and cancer of the uterine lining. The presence of these cancers increases the risk for people who have breast cancer. Patients with BRCA 1 or BRCA2 mutations, in particular, have an increased risk of developing various types of cancer.


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