Dedicated to Charlene Circele

Here’s the problem:  We have no way of knowing who will get breast cancer.

Why?  Because breast cancer is a very tricky disease, to put it mildly.

Well, then, if we don’t know who will get breast cancer can we say with any degree of certainty who might be at an increased risk for breast cancer?  Why, yes, of course.  Scientists have identified several risk factors that definitely increase a woman’s risk for breast cancer.  However, having these risk factors is no guarantee that breast cancer is inevitable; and not having them is certainly no guarantee that you have nothing to worry about.

As an example, women who carry a BRCA mutation have the highest risk for breast cancer.  On average, the lifetime risk is in the range of 50-85%, depending on exactly which of the many varieties of BRCA mutation a woman was born with.  But take a look at that range again and you can begin to appreciate that not every woman with a BRCA mutation goes on to develop breast cancer.  And, so, even in this group of very “high risk” women we can’t say for sure who will get the disease and who will not.  Alas.

What are the other risk factors for breast cancer and how reliable are they in predicting the likelihood that a particular woman will get the disease?  Here they are: a positive family history, a history of cigarette smoking, obesity, a high fat diet, a history of using oral contraceptives in the past 10 years, a history of using hormone replacement therapy in the past two years, and any amount of alcohol consumption.  These are the most well studied risk factors that increase the likelihood that a woman will get breast cancer.  Unfortunately, these risk factors are much less predictive than a BRCA mutation in increasing the likelihood that a woman might get breast cancer.  Not exactly reassuring, right?

And then there’s an even thornier problem, which is that the vast majority – at least 80% – of women who actually develop breast cancer don’t have ANY identifiable risk factor, none whatsoever.  Oh dear, we haven’t come very far in the race if we don’t know what’s causing this disease, have we?

To boil it down to the only thing we know for sure:  the main risk factor for breast cancer rests on being female.  Over 99% of the cases of breast cancer occur in women; only 1% occur in men.

But there’s something brewing on the horizon that may help sort out these risk factors against what might be the biggest risk factor of all.  In fact, it might make them far less important than the risk factor currently under investigation – the breast cancer virus.  You see, the main risk factor for cervical cancer is infection with the human papilloma virus (HPV).  (And, as you know, we have a vaccine that prevents that.)  More and more, it’s looking like at least one, perhaps more than one, virus is at the root of human breast cancer.

To learn more about this virus, I would like to refer you to a presentation given by Professor James Holland, past president of the American Society for Cancer Research and also past president of the American Association for Cancer Research.  Dr. Holland was invited to give a presentation on his 30 years of research on the human breast cancer virus at the 60th anniversary celebration of the Clinical Center of the National Institutes of Health in July, 2013.  Do yourself a favor and fast-forward about 20 minutes into this video, which is archived at the National Library of Medicine, past the introductions and listen to Dr. Holland present to an auditorium filled to the rafters with scientists from around the world the fascinating work that has been done on the human breast cancer virus:  bit.ly/HollandNIH

If you want to read more about this fascinating research, take a peek at OF MICE AND WOMEN:  Unraveling the Mystery of the Breast Cancer Virus. bit.ly/PinkVirusBook

And if you want to be first up to know all the latest news in breast cancer research follow me on Twitter @DocRuddy

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