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Breast cancer is the most common form of cancer to affect New Zealand women, with one in nine of us receiving this diagnosis at some point in our lives. Even so, the causes of this disease are not yet known.

On this page we list the known risks for breast cancer and give an indication of their relative importance. We also look at steps you can take that could lower your chances of getting breast cancer. 

Risks

Factors that are known to increase your risk of getting breast cancer are, in order of magnitude:

• Being a woman - some men get breast cancer, but they represent less than 1% of all cases.

• Getting older - 50-year-old women are 10 x more likely to get breast cancer than 30-year-olds.

• Having certain genetic mutations - BRCA1 and BRCA2 are the best known; PALB2, TP53 and PTEN are more recently discovered. These mutations are not at all common but those carrying them have a 3- to 5-fold higher risk of breast cancer than the general population. You can be screened for these mutations if you have a strong family history of breast cancer*.

• Having several close relatives, such as a mother, sister, or daughter, who have been diagnosed with the disease - the more relatives, the greater the risk, ranging from 1.5 to 3.9 x the risk of those with no relatives with breast cancer.

• Having had breast cancer before – 1.55 to 3.9 x risk compared to those who have not.

• Using combined (oestrogen and progesterone) menopausal hormone therapy – 1.72 x risk, while you are taking it.

• Having dense breasts (as shown on a mammogram) – those with greater-than-average density have 1.53 x risk of those with less dense breasts.

• Periods starting when only 10 years old – 1.19 x risk compared to those who started at 13.

• Having your first child at over 30 years old – 1.2 x risk compared to before age 30.

• Having no children – 1.16 x risk compared to women who have had children. The more children you have, the lower your risk.

• Late menopause – those reaching menopause at 55 years or older have 1.12 x risk of those reaching menopause at 50 to 54 years.

• Greater than average height – those who are 172cm tall have 1.17 x risk of those who are 162cm.

• Higher than average Body Mass Index after menopause – those who are overweight (BMI > 27 kg/m2) have 1.12 to 1.4 x risk; the greater the BMI the higher the risk.

• Weight gain after menopause – gaining 5 to 20 kg after menopause increases risk by 1.06 to 
1.26 x.

• Alcohol consumption – those who drink 2 to 6 drinks per day have 1.15 to 1.5 x risk of those who do not drink alcohol.

Factors that probably increase your risk of breast cancer are: 

• Never breastfeeding – 1.05 x the risk of those who have breastfed.

• Low physical activity – physically active pre- and post-menopausal women have a 13 to 17% lower risk of breast cancer than those who are least active.

• Having had a high birthweight – babies weighing 4kg or more at birth have 1.99 x risk of getting breast cancer before menopause, compared to those weighing less than 2.5kg.

If you have these risk factors, it does not mean you will get breast cancer, but you may be more likely to than some other women. However, most women who get breast cancer have no known risk factors, other than getting older.

* Note: Genetic Health Service NZ (GHSNZ) has recently made changes to the way in which people who have a family history of breast cancer are assessed. These changes have come about following international changes to both risk assessment software and the revised criteria for genetic testing. The updated assessment process has resulted in a lowering of the estimated risk and revised surveillance recommendations for some families. If your family was seen by GHSNZ prior to November 2016, you may wish to discuss the possibility of a re-referral to the Genetic Service with your doctor. (July 2017)

Can I prevent breast cancer?

There's no way to prevent breast cancer, but you can take steps to try and decrease your chances of contracting this disease.

Preventative steps that may decrease your risk of breast cancer, include:

• Maintaining high levels of physical activity – including walking, household activities, occupational activities and vigorous activities like running or fast cycling.

• Maintaining a healthy weight, especially after menopause.

• Reducing your consumption of alcohol.

• Drugs known as aromatase inhibitors lower the risk of new breast cancers occurring in post menopausal women with a history of breast cancer.

• Many dietary factors have been investigated for possible links to breast cancer, but obtaining conclusive evidence for these is challenging. There is suggestive evidence that dietary calcium (not supplements), dairy, non-starchy vegetables and foods high in carotenoids (orange and yellow fruits and vegetables) can reduce breast cancer risk, and that processed meat could increase risk.

Find out more

This factsheet shows the proven risk factors for breast cancer and their magnitude. The full report is here. 

A diagnosis of breast cancer is a life-changing moment for more than 3000 New Zealand women every year.

If you are one of these women - BCAC and the Step by Step support pack are here to help.

Step by Step provides information and resources for women at the difficult time of a breast cancer diagnosis. 

BCAC’s members know from personal experience that this is the beginning of a challenging journey, and we have developed this pack specifically for New Zealand women.

The information contained in each pack will help women understand their diagnosis, empower them to ask questions of their medical team and so make informed choices about their treatment options.

Each Step by Step pack contains:

• An information booklet about breast cancer, treatments, support organisations and other useful resources. You can look at a copy of this here.
• A diary to organise medical and treatment information, record appointment times and note down any questions women may wish to ask their medical teams. 
• A journal for recording personal thoughts, with inspirational messages from other women who have experienced breast cancer.

To order your free Step by Step support pack, please fill in the form below and we will send you one immediately.

Telling family and friends of your diagnosis can be one of the hardest parts of dealing with breast cancer.  

You may be feeling scared, confused and uncertain. It may be difficult for you to tell those you love about your diagnosis and to deal with their emotions as well. If you’re finding it hard to tell others of your diagnosis, you may prefer to ask a close family member or friend to talk to people for you.

Friends and family may need time to absorb and process this challenging information. They may not know what to say or do, but with time and understanding will find the strength to support you.

Your friends and family can help you to fight breast cancer. So rely on them, talk to them, and let them help you in any way they can.

Telling your children

If you have children, how much you tell them will depend on how old they are. Give them age-appropriate information and make sure you are honest with them. You don’t burden them with too many details, but you should make sure they understand what is happening and what it will mean for them. 

Don't try to keep crucial information from your children. Frequently they will know that something is being kept from them and they will imagine the worst.

Make sure you let them know what will be happening for them while you are receiving treatment and who will be looking after them.
 
This will be a difficult time for children and they will react in different ways. Seek help for them from a counsellor if you think they need it.

Check out our page on children for more information on supporting children and teenagers.

There’s lots of helpful information on talking to children in the New Zealand Cancer Society’s booklet Cancer in the family: Talking to your children.

Telling your employer

It can be unsettling telling your employer that you have breast cancer and that you will need time off for treatment. You may wonder how your employer will react, what it will mean for your future job security, and how you will feel about returning to work when the time comes.

Most employers are understanding and will give you leave without pay for treatment, if you do not have extensive sick leave. If you are self-employed it may be more difficult for you take time out for treatment. 

Try not to stress about work issues at this time. You need to focus on your health and wellbeing so that you can get better as quickly as possible. 

If your cancer treatment means you face financial hardship, contact Work and Income New Zealand to see what assistance they can provide. They offer financial assistance through a variety of allowances including a Supported Living Payment. 

If you are struggling financially, the New Zealand Cancer Society provides grants to assist individuals and families. These grants cover things such as transport costs, household expenses, special equipment, counselling services etc. Find out more.

Before you start treatment, you will need to decide who will make up your medical team. 

Your team of cancer specialists could include:

• a surgeon
• a breast care nurse
• a medical oncologist
• a radiation oncologist

You will probably be referred to a surgeon in the first instance.  Make sure you feel comfortable with this person.  Things to consider include:

• Do you feel able to ask as many questions as you want to?
• Does your surgeon/oncologist provide you with fulsome answers that satisfy your need to know?
• Do you feel able to spend as much time as you need discussing your case with your doctor?
• Do you feel your doctor takes your concerns seriously?

Remember, if you're receiving care through the public health system, you may not see the same oncologist at every appointment.  If you want to see the same person each time, you may have to consider paying for private treatment.

If you have any doubts about your medical care, seek a second opinion. To do this:

• Have a lengthy discussion with your GP about the best specialist to meet your particular needs
• Ask others who have experienced treatment for breast cancer who they recommend
• Remember that you are entirely within your rights to seek a second opinion and medical professionals should feel comfortable wtih this course of action, not offended.

New Zealand now has guidelines for the management of early breast cancer which outline the best practice treatment methods for early breast cancer.  All medical professionals should be meeting the standards outlined in these guidelines.

Receiving a diagnosis of breast cancer can be challenging and frightening.

On these pages, you'll find more information about how to cope with and understand your diagnosis.  We hope this will help you to make informed decisions about your treatment programme.