Rating the risk factors for breast cancer.
OBJECTIVE
To update and summarize evidence of risk factors for breast cancer.


BACKGROUND
Women who are at high risk for breast cancer have a variety of options available to them, including watchful waiting, prophylactic surgery, and chemoprevention. It is increasingly important to accurately assess a patient's risk profile to ensure that the cost/benefit ratio of the selected treatment is favorable.


METHODS
Estimates of relative risk for documented risk factors were obtained from seminal papers identified in previous reviews. These estimates were updated where appropriate with data from more recent reports using large sample sizes or presenting meta-analyses of previous studies. These reports were identified from a review of the Medline database from 1992 to 2002.


RESULTS
Risk factors that have received a great deal of publicity (hormone use, alcohol consumption, obesity, nulliparity) present a relatively modest relative risk for breast cancer (<2). Factors associated with a prior history of neoplastic disease or atypical hyperplasia and factors associated with a genetic predisposition significantly affect the risk of breast cancer, with relative risks ranging from 3 (for some cases of positive family history) to 200 (for premenopausal women positive for a BRCA mutation).


CONCLUSIONS
More precise tools, based on techniques of molecular biology such as microarray analysis, will be needed to assess individual risk for breast cancer.
Singletary
S Eva
SE
Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 444, Houston, TX 77030-4095, USA. esinglet@mdanderson.org
D000428:Alcohol Drinking / Q000009:adverse effects; D035843:Biomedical Research; D015992:Body Mass Index; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000235:genetics; D004777:Environment; D005544:Forecasting; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D006965:Hyperplasia; D008019:Life Style; D008962:Models, Theoretical; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology; D012098:Reproduction; D012306:Risk; D018570:Risk Assessment