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• Personal history of breast cancer―Women who have had breast cancer are more likely to develop a second breast cancer.
• Family history―A woman’s chance of developing breast cancer increases if her mother, sister, and/or daughter have been diagnosed with the disease, especially if they were diagnosed before age 50. Having a close male blood relative with breast cancer also increases a woman’s risk of developing the disease.
  
• Genetic alterations (changes)―Inherited changes in certain genes (for example, BRCA1,BRCA2, and others) increase the risk of breast cancer. These changes are estimated to account for no more than 10 percent of all breast cancers. However, women who carry certain changes in these genes have a much higher risk of breast cancer than women who do not carry these changes.
• Breast density―Women who have a high percentage of dense breast tissue have a higher risk of breast cancer than women of similar age who have little or no dense tissue in their breasts. Some of this increase may reflect the “masking” effect of fibroglandular tissue on the ability to detect tumors on mammograms (see Question 4).
• Certain breast changes found on biopsy―Looking at breast tissue under a microscopeallows doctors to determine whether cancer or another type of breast change is present. Most breast changes are not cancer, but some may increase the risk of developing breast cancer. Changes associated with an increased risk of breast cancer include atypical hyperplasia (a noncancerous condition in which cells have abnormal features and are increased in number), lobular carcinoma in situ (LCIS) (abnormal cells are found in thelobules of the breast), and DCIS. Because some cases of DCIS will eventually become cancer, this type of breast change is actively treated (see Question 4). Women with atypical hyperplasia or LCIS are usually monitored carefully and not actively treated. In addition, women who have had two or more breast biopsies for other noncancerous conditions also have an increased risk of developing breast cancer. This increased risk is due to the conditions that led to the biopsies and not to the biopsy procedures.
• Reproductive and menstrual history―Women who had their first menstrual period before age 12 or who went through menopause after age 55 are at increased risk of developing breast cancer. Women who had their first full-term pregnancy after age 30 or who have never had a full-term pregnancy are also at increased risk of breast cancer.
• Long-term use of menopausal hormone therapy―Women who use combined estrogenand progestin menopausal hormone therapy for more than 5 years have an increased chance of developing breast cancer.
• Radiation therapy―Women who had radiation therapy to the chest (including the breasts) before age 30 have an increased risk of developing breast cancer throughout their lives. This includes women treated for Hodgkin lymphoma. Studies show that the younger a woman was when she received treatment, the higher her risk of developing breast cancer later in life.
• Alcohol―Studies indicate that the more alcohol a woman drinks, the greater her risk of breast cancer.
• DES (diethylstilbestrol)―The drug DES was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage. Women who took DES during pregnancy may have a slightly increased risk of breast cancer. The effects of DES exposure on breast cancer risk in their daughters are unclear and still under study.
• Body weight―Studies have found that the chance of getting breast cancer after menopause is higher in women who are overweight or obese.
• Physical activity level―Women who are physically inactive throughout life may have an increased risk of breast cancer. Being active may help reduce risk by preventing weight gain and obesity.

Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread. Results from randomized clinical trials and other studies show that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74, especially for those over age 50 (1, 2). However, studies conducted to date have not shown a benefit from regular screening mammography in women under age 40 or from baseline screening mammograms (mammograms used for comparison) taken before age 40.

1. National Cancer Institute: Breast Cancer Screening (PDQ®)―Health Professional. Date last modified 09/03/2010. Available at:http://www.cancer.gov/cancertopics/pdq/screening/breast/HealthProfessional. Accessed 09/17/2010.
2. Mandelblatt JS, Cronin KA, Bailey S, et al. Effects of mammography screening under different screening schedules: Model estimates of potential benefits and harms. Annals of Internal Medicine 2009; 151(10):738–747. [PubMed Abstract]

(Source: National Cancer Institute)