The dictum "DETECTION IS BETTER THAN CURE" is very applicable to breast cancer -- if breast cancer is detected at an early stage, the patient's life can be saved in up to 95% of the cases. Indeed, the high mortality due to breast cancer is due to the delayed diagnosis of the disease.

Early breast cancer usually does not cause pain. In fact, when breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch out for:

As a general caveat, it must be noted that women who do have one or more of these risk factors do not always develop breast cancer. Also, many women who do develop breast cancer do not have any risk factors.

Among the risk factors that contribute to breast cancer, early puberty and late menopause are similar as both are mainly due to prolonged exposure to estrogen. The role of estrogens in breast cancer risk during pre-menopausal periods is largely unknown. The level of receptors is thought to play an important role in breast cancer, as an excessive increase in the number of receptors can cause uncontrolled cell proliferation. If the number of estrogen receptor >10 fMol/milligram cytosol protein, then it is considered as estrogen receptor positive and less than that value is considered as estrogen receptor negative. The prognosis for those patients with breast cancer where estrogen receptors are implicated is better than those patients with normal estrogen receptor count, whose breast cancer could be due to other reasons.

While discussing risk assessment, the following factors should be considered:

• the number of affected relatives
• age at diagnosis and
• the degree of closeness between relatives of family members
• Presence of bilateral/multifocal breast cancer
• Presence of other cancers such as ovarian cancer
• Involvement of male breast cancer

( Source - GeneClinics ).

Recent research reports also indicate that height may be associated with breast cancer risk in post menopausal women. A research study in Netherland has shown that risk of breast cancer increased by 7% for each 5 cm increase in height in post menopausal women [19] .

In a pioneering work on risk factor assessment by Gajalakshmi  et al.,  the family history of breast cancer and late child birth emerged as strong risk factors for contralateral breast cancer. This group also studied risk factors of female breast cancer at both premenopausal and postmenopausal stages. They found that age at menarche was independent of breast cancer risk. Unmarried women had an increased risk and furthermore, nulliparity was a risk factor in pre- menopausal women alone.

Detailed studies on various risk factors and biological markers for breast cancer have been conducted in India by independent research groups. Links to these studies are given here.

Scientists at the National Cancer Institute have developed a breast cancer risk assessment tool to estimate the women's risk of developing breast cancer over a period of five years and over the life time.

There are two models which describe the risk assessment in breast cancer. The Claus model discusses the risk level based on family history of breast cancer [34].The Gail model focusses on non-genetic risk factors with limited information on family history [35] .

A statistical model - BRCAPRO is available based on personal and family history characteristics to identify the presence of any germline mutation (BRCA1 or BRCA2).