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Breast Cancer Risk Factors: What Raises It, What Doesn't

Most breast cancer happens in women with no risk factor beyond being female and older. Here is what the NHS, CDC and WHO list as raising risk, what the research does not support (deodorant, abortion, bras), and what to do about a family history.

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Most breast cancer is not explained by anything a woman did or did not do. The WHO says that approximately 80% of breast cancers develop in women who have no modifiable breast cancer risk factor other than being female and over 40. Known risk factors do exist: age, family history and inherited genes, dense breasts, hormonal and reproductive history, alcohol, smoking, weight after menopause and inactivity. Some popular fears, such as deodorant and abortion, are not supported by the research we read.

This piece goes through what the sources list, what they do not, and what anyone can do with the information. None of it is a verdict on how someone has lived. Most of the things on these lists are not choices at all, and the ones that are were made for reasons that are nobody else's business.

What is a risk factor, and what is it not?

A risk factor is something that makes an illness more likely across a large group of people. It is not a prediction about one person. The NHS puts it plainly: anyone can get breast cancer and it is not always clear what causes it.

It works the other way too. The CDC says some women will get breast cancer even without any other risk factors. That is why the advice to know what is normal for your breasts applies to everyone, not only to women who tick boxes on a list.

Which risk factors can I not change?

These are the ones both the NHS and the CDC list:

  • Age. The CDC says the risk increases with age and most breast cancers are diagnosed after age 50. The NHS lists being over 50.
  • Being female. The WHO calls female gender the strongest risk factor: approximately 99% of breast cancers occur in women and 0.5 to 1% in men.
  • Family history and inherited genes. The NHS says you may be more likely to get breast cancer if other people in your family have had breast or ovarian cancer, as you may have inherited a faulty gene such as a faulty BRCA gene. The CDC says risk may be higher if a mother, sister or daughter has had breast cancer.
  • Dense breast tissue. Both list it. The CDC says dense breasts can sometimes make tumours hard to see on a mammogram, and women with dense breasts are also more likely to get breast cancer.
  • Some breast conditions. The NHS names benign breast disease, ductal carcinoma in situ and lobular carcinoma in situ. The CDC adds that women who have had breast cancer are more likely to get it a second time, and that some non-cancerous breast diseases, such as atypical ductal hyperplasia, are linked to a higher risk.
  • Hormonal history. The NHS says starting periods before 12 or going through menopause after 55 can mean higher hormone levels, which may make breast cancer more likely.
  • Radiation to the chest. The CDC says women who had radiation therapy to the chest or breasts before age 30 have a higher risk.

The CDC also lists DES, a drug some pregnant women in the United States were given between 1940 and 1971 to prevent miscarriage. Women who took it have a higher risk, and the CDC says their daughters may too.

What about having children and breastfeeding?

Both sources include them. The NHS says higher hormone levels, and so a higher chance of breast cancer, may be more likely if you have not given birth, gave birth for the first time after 30, or did not breastfeed. The CDC says the same about a first pregnancy after 30, not breastfeeding and never having a full-term pregnancy.

These are on the list because they are true across large groups. They are not a reason to have a baby, to have one sooner, or to feel anything at all about a feeding choice already made. Whether, when and how is your decision, and the size of this effect is something to ask a doctor about if it matters to you.

Does the pill or HRT cause breast cancer?

The NHS says using the contraceptive pill in the last 10 years, or taking hormone replacement therapy, only slightly increases your risk, and that for many people the benefits of taking them outweigh the risks. The CDC names forms of HRT that include both oestrogen and progesterone.

Neither source says to stop. Both the NHS and the CDC say to talk it over with your doctor, which is the right place for a decision that weighs one risk against real benefits.

Which risk factors can I change?

The NHS says you cannot always prevent breast cancer, but lists things that can lower your chance of getting it:

  • try to cut down on alcohol and avoid drinking more than 14 units a week
  • try to lose weight if you are overweight
  • try to quit smoking
  • talk to a GP if you are worried about how the pill or HRT may affect your risk

The CDC prevention page adds being physically active and says even moderate drinking, one drink a day, may increase the risk. Its risk factors page says a woman's risk increases the more alcohol she drinks, and that older women who are overweight have a higher risk.

These are odds across a population, not a scorecard. Plenty of women who do all of this still get breast cancer, and plenty who do none of it never do.

Do deodorants or antiperspirants cause breast cancer?

The research we read does not show that they do, though it is thinner than you might expect.

A 2002 study of 813 women with breast cancer and 793 without, aged 20 to 74, found that risk did not increase with antiperspirant or deodorant use, with using them after shaving with a blade razor, or with applying them within an hour of shaving. A 2016 systematic review found only two studies to pool and said that was not enough to give reliable results.

A 2023 review on aluminium found that six studies on deodorant and antiperspirant use did not produce consistent results, and that the clinical studies were small and retrospective. Its authors still suggested, as a precaution, avoiding antiperspirants that contain aluminium, and said deodorants without aluminium are not implicated in breast cancer. That is their precautionary view, not a finding that aluminium causes it. Neither the NHS nor the CDC lists either product as a risk factor.

Does abortion or miscarriage raise the risk?

No, according to the largest analysis we found. A 2004 reanalysis in The Lancet pooled data from 53 studies in 16 countries, covering 83,000 women with breast cancer, and concluded that pregnancies ending in a miscarriage or an abortion do not increase a woman's risk. It found that earlier studies which asked women about past abortions after a diagnosis gave misleading results, possibly because women with breast cancer were more likely to disclose them.

What about bras?

Bras have an article of their own. In short, the research we found does not support a link, and neither the NHS nor the CDC lists bras as a risk factor.

Is breast cancer different for Black women?

The signs to look for are the same, but there is one difference in how a change can look. The NHS says a change in the colour of the skin on the breast may look darker than usual on black or brown skin, and red on white skin. A leaflet showing only redness can miss that.

In US data, the CDC report on breast cancer in women younger than 45 found that non-Hispanic Black women had the highest breast cancer death rate of any racial or ethnic group from 2001 to 2023, and that those diagnosed before 45 were less likely to be alive five years later than other women. Fewer were diagnosed at a localised stage and more at a distant stage. The CDC's advice to young women is to talk to a doctor about family history and other risk factors, and to see a health care provider about any change in the breasts.

I have a family history. What should I do?

Talk to a GP or your own doctor, even if you feel well. The NHS says that if close relatives have had breast or ovarian cancer you may be eligible for an NHS genetic test, which checks for a faulty gene such as BRCA. The GP may ask who in your family had cancer, which type, how old they were when diagnosed, and whether they have been tested. If they think your risk is raised, they refer you to a specialist breast or genetics clinic. The NHS also offers BRCA testing to anyone 18 or over with one or more Jewish grandparents.

For people at higher risk, the NHS says a doctor or genetic counsellor can discuss treatments that lower it, including medicines and, at very high risk, surgery. The CDC says to ask about screening and risk-lowering medicines.

The NHS symptoms page adds one specific point: breast pain alone is not usually a symptom of breast cancer, but see a GP if you have breast or armpit pain and other people in your family have had breast or ovarian cancer.

When does screening start?

It depends on where you live. In England, NHS breast screening is offered to women from 50 up to their 71st birthday, every 3 years. In the United States, ACOG recommends a screening mammogram every 1 to 2 years from age 40 for women at average risk, continuing until at least 75. ACOG counts you as higher risk with a family history of breast, ovarian or other inherited cancers, a BRCA1 or BRCA2 mutation, chest radiation at a young age, or a high-risk biopsy result.

Screening is for women with no symptoms. If you notice a change, do not wait for an invitation: the NHS says to see a GP even if you have recently had screening. Knowing what is normal for you matters too: ACOG says women find breast cancer themselves in almost half of cases at 50 and over, and in more than 70% of cases under 50. How to Check Your Breasts walks through the NHS method, and Breast Lumps: Most Are Not Cancer covers what happens if you find something.

The short version

Most breast cancer happens in women with no risk factor other than being female and getting older, so knowing your normal matters for everyone. The NHS and CDC list age, family history and inherited genes, dense breasts, some breast conditions, hormonal and reproductive history, the pill and HRT (a slight increase), radiation to the chest, alcohol, smoking, weight after menopause and inactivity. The research we read does not support deodorant, antiperspirant, abortion or bras as causes. If breast or ovarian cancer runs in your family, talk to a doctor about genetic testing and screening, and see a doctor about any change that is not normal for you.

Sources

This article describes what those sources say. It is not medical advice, and it is not a substitute for a doctor, nurse or pharmacist.

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