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“It’s tough making predictions, especially about the future”,
a statement attributed to many individuals before me

by Dr. Mai Brooks

Breast cancer is the most common malignancy in American women. Approximately one out of eight women will develop breast cancer in their lifetime. It would be so nice to tell ahead of time which is the unlucky one out of every eight patients. But there is simply no reliable method to accurately predict the future occurrence of breast cancer in any one individual patient. Everyone must understand that the individual breast cancer risk calculated by mathematical models merely refers to the group of women that the individual patient belongs to.

The consensus opinion in the field of breast cancer research is that there is no known cause for this most common disease, with the exception of the BRCA gene, which accounts for a very small percentage of breast cancer cases. While many risk factors for breast cancer have been identified, risk does not equal cause.

In various population studies, some clinically significant risk factors have been identified, including but not limited to first degree family history, atypical ductal hyperplasia (ADH), lobular carcinoma in situ (LCIS), and radiation exposure. Other population studies have reported “soft” risk factors, such as obesity, alcohol consumption, tobacco use, sedentary lifestyle, hormone replacement therapy, previous benign breast biopsies, age at first childbirth, and others.

However, on an individual basis, there is no reliable method to predict who will develop breast cancer. Furthermore, there is no way to determine what role, if any, a particular risk factor plays in the development of an individual’s breast cancer, with the exception of a genetic link (BRCA gene). In an individual woman, identification of specific risk factors is absolutely not the same as identification of any cause or contributing factor to the development of breast cancer.

Therefore, if you should become diagnosed with breast cancer, you should not blame yourself. Sure, you could have eaten more healthily and exercised more, but there was absolutely nothing you could do to guarantee that breast cancer would never happen to you. The only risk factor that rises to the level of a causative role is the BRCA gene, and most certainly you could not have picked your own biological parents.

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