Introduction

Cells in the breast normally reproduce only when new cells are needed. Sometimes, cells in a part of the body grow and divide out of control, which creates a mass of tissue called a tumor. If the cells that are growing out of control are normal cells, the tumor is called benign (not cancerous).

If, however, the cells are abnormal and aren’t functioning properly, the tumor is called malignant (cancerous) and can be found in different types and stages.

While we don’t yet know exactly what causes breast cancer, we do know that certain factors can increase the risk of disease.  According to the American Cancer Society, the risks include:

• Gender. While men can also get breast cancer, it is approximately 100 times more common in women. (Click here for more information about breast cancer in men.)
  
  
• Age. Nearly eight out of 10 breast cancers are found in women age 50 or older.
  
  
• Genetics. Between 5% and 10% of breast cancers are linked to mutations (changes) in certain genes.  The most common gene changes are those of the BRCA1 and BRCA2 genes.  Women with these mutations have up to an 80% chance of getting breast cancer during their lifetimes.
  
  
• Family history. Breast cancer risk is higher among women whose close blood relatives – from either the mother’s or father’s side of the family – have been diagnosed with breast cancer.
  
  
• Race. White women are slightly more likely to get breast cancer than are African-American women, but African-American women are more likely to die of the disease.  Asian, Hispanic, and American-Indian women have lower risks of breast cancer.
  
  
• Not having children. Women who have not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer.  Being pregnant more than once and at an early age reduces the risk of breast cancer. 
  
  
• Hormone replacement therapy (HRT). Long-term use of estrogen combined with progesterone after menopause increase the risk of breast cancer.  Estrogen replacement therapy (ERT), used alone, does not appear to increase the risk of breast cancer.  
  
  
• Other risk factors. Alcohol use, obesity, and high-fat diets can increase the risk of getting breast cancer.  Studies have also demonstrated that regular exercise can reduce the risk of breast cancer.

It should be noted that the majority of breast cancers occur in women with no obvious risk factors.  In other words, all women are at risk for breast cancer and should take steps to protect themselves.

The Bad

Aside from skin cancer, breast cancer is the most common cancer among women.  It is the second leading cause of cancer death in women, after lung cancer.

Every year, approximately 180,000 American women are diagnosed with breast cancer and approximately 40,000 will die from the disease. Right now, more than 2 million women living in the United States have been treated for breast cancer.

The Good

Even though rates of breast cancer are increasing in the United States, this is likely due to increased efforts to diagnosis the disease. These efforts, such as routine self breast exams and regular mammograms, can help detect breast cancer in its earliest stages, when it is still confined to the breast and has not spread to the lymph nodes or other organs.  There is a five-year survival rate of 97%, if breast cancer is detected in its earliest stages.

The risk of breast cancer is serious, but it is less common than other life-threatening diseases.  For example, less than 4% of American women die of breast cancer, while approximately 30% die of heart disease.

Why is it LGBT?

According to information published by the King County (Washington State) Department of Public Health and other resources, being a lesbian does not increase the risk for breast cancer, but there are risk factors to consider:

• Lesbians are less likely to seek routine health care because of the discomfort of coming out to healthcare providers and less access to health insurance. With fewer doctor visits, lesbian and bisexual women are less likely to have mammograms and professional breast exams. Studies also show that lesbian and bisexual women are less likely to perform breast self-exams regularly. For these reasons, lesbians and bisexual women may be less likely to have cancers detected at earlier, more treatable, stages.
  
  
• Lesbians are less likely to give birth by age 30 if at all, which increases the risk.
  
  
• Some studies suggest that lesbians may use alcohol more and have higher body weight, both of which may increase a woman's risk for breast cancer.
  

For additional Information about breast health and cancer concerns among lesbians, check out the Mautner Project.

What to Do

The most common sign of breast cancer is a new lump or mass. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But some cancers are tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.

Other signs of breast cancer include the following:

• a swelling of part of the breast

• skin irritation or dimpling

• nipple pain or the nipple turning inward

• redness or scaliness of the nipple or breast skin

• a nipple discharge other than breast milk

• a lump in the underarm area

Be sure to report any symptoms to your healthcare provider.

Tools

The American Cancer Society recommends the following guidelines for finding breast cancer early:

• Mammogram. Women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health. While mammograms can miss some cancers, they are still a very good way to find breast cancer.
  
  
• Clinical breast exam. Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a regular exam by a healthcare provider, preferably every 3 years. After age 40, women should have a CBE by a healthcare provider every year. It might be a good idea to have the CBE shortly before the mammogram. You can use the exam to learn what your own breasts feel like.
  
  
• Breast awareness and breast self-exam (BSE). BSE is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any changes in how their breasts look or feel to their health professional right away.
  
  If you decide to do BSE, you should have your doctor or nurse check your method to make sure you are doing it right. You can also learn how to do BSEs by watching an interactive program from the Susan G. Komen Breast Cancer Foundation. 
  
  The most important thing is to see your doctor right away if you notice any of the symptoms listed in the “What to Do” section of this fact sheet. 
  
  
• Women at high risk. Women with a higher risk of breast cancer should talk with their doctor about the best approach for them. This might mean starting mammograms when they are younger, having extra tests, or having more frequent exams.