Which of the following are factors associated with an increased risk for developing breast cancer?

a. Nulliparity

d. High-fat, high-caloric diet

Women who undergo oophorectomy before age 35 and do not take replacement estrogens have a two-thirds reduction in their breast cancer risk. Replacement estrogen therapy eliminates the beneficial effect of oophorectomy. Most investigations of oral contraceptive use do not demonstrate an associated increased risk of breast cancer development. Studies of estrogen replacement therapy for post-menopausal women have yielded equivocal results. Most contemporary studies fail to demonstrate an association between breast cancer risk and post-menopausal use of conjugated estrogens

BREAST CANCER RISK FACTORS

DEMOGRAPHIC FACTORS

Age more than 30 y

Female gender (130:1 female/male ratio)

GREATLY INCREASED RISK

Known carrier of breast cancer susceptibility gene

Strong family history—two or more first-degree relatives with

bilateral or premenopausal breast cancer

Atypical ductal or lobular hyperplasia or lobular carcinoma in situ

Ductal carcinoma in situ, risk limited to ipsilateral breast

MODERATELY INCREASED RISK

Family history—one or more relatives with breast cancer, not

bilateral or premenopausal Menstrual history—menarche before age 12 y, menopause after

age 55 y

Parity—nulliparity or first live birth after age 30 y Radiation—exposure to low-dose ionizing radiation in childhood or adolescence

Previous breast cancer—low-grade, node-negative, or receptorpositive; lobular histology

Other cancers—colon or endometrial cancer

Diet—high-fat or high-calorie diet