Rapidly increasing incidence of breast cancer is a new social challenge resulting from a spectrum of internal and external risk factors which appear to be well accepted as an attribute of the early twenty-first century, being, however, new for female sub-populations compared to the past. These include altered socio-economical conditions such as occupational exposure, rotating shift work, specific environmental factors (increased pollution and environmental toxicity, altered dietary habits, quality and composition of meal) as well as consequently shifted and/or adapted physiologic factors such as lower age at menarche, late age of first full-term pregnancy, if any, shorter periods of breastfeeding and later menopause. Consolidated expert statements suggest that over 50 % of all breast cancer cases may be potentially prevented by risk reduction strategy such as regulation of modifiable risk factors. Currently available risk assessment models may estimate potential breast cancer predisposition, in general; however, they are not able to predict the disease manifestation individually. Further, current deficits in risk assessment and effective breast cancer prevention have been recently investigated and summarised as follows: gaps in risk estimation, preventive therapy, lifestyle prevention, understanding of the biology of breast cancer risk and implementation of known preventive measures. This paper overviews the most relevant risk factors, provides recommendations for improved risk assessment and proposes an extended questionnaire for effective preventive measures.

Biomedical Centre Faculty of Medicine in Pilsen Charles University Prague Pilsen Czech Republic

Breast Cancer Research Centre Rheinische Friedrich Wilhelms University of Bonn Bonn Germany

Department of Biology Faculty of Medicine in Pilsen Charles University Prague Pilsen Czech Republic

Department of Obstetrics and Gynaecology Centre for Integrated Oncology Rheinische Friedrich Wilhelms University of Bonn Bonn Germany

Department of Radiology Rheinische Friedrich Wilhelms University of Bonn Bonn Germany

European Medical Association Brussels Belgium

Faculty of Medicine and Surgery University of Malta Msida Malta

Zobrazit více v PubMed

EPMA J. 2010 Mar;1(1):130-7 PubMed

Cancer Causes Control. 2001 Feb;12(2):95-101 PubMed

J Clin Oncol. 2008 Feb 10;26(5):768-77 PubMed

Breast Cancer Res Treat. 2013 Dec;142(3):569-78 PubMed

EPMA J. 2011 Dec;2(4):351-6 PubMed

Am J Public Health. 1996 Nov;86(11):1577-81 PubMed

Clin Med Insights Gastroenterol. 2013 Aug 14;6:33-47 PubMed

Prev Med Rep. 2014 Nov 28;2:15-20 PubMed

Cancer Epidemiol Biomarkers Prev. 1995 Jul-Aug;4(5):567-71 PubMed

Biol Trace Elem Res. 2010 Aug;136(2):127-39 PubMed

Breast Cancer Res Treat. 2012 May;133(1):127-35 PubMed

Cancer. 1985 Jun 1;55(11):2698-708 PubMed

Curr Treat Options Oncol. 2016 Aug;17(8):39 PubMed

Int J Cancer. 2012 Dec 1;131(11):2547-52 PubMed

BMJ Open. 2012 Jan 11;2(1):e000647 PubMed

Sleep. 2013 Oct 01;36(10):1437-44 PubMed

Med Sci Sports Exerc. 2000 Jul;32(7):1250-7 PubMed

Int J Sports Med. 2002 May;23 Suppl 1:S39-43 PubMed

Tob Control. 2011 Jan;20(1):e2 PubMed

Clin Cancer Res. 2009 Jan 15;15(2):425-30 PubMed

Eur J Cancer. 2002 Jan;38(1):27-43 PubMed

Breast Cancer Res Treat. 2010 Aug;122(3):699-710 PubMed

Scand J Work Environ Health. 2010 Mar;36(2):81-4 PubMed

Clin Cancer Res. 2013 Dec 1;19(23):6389-97 PubMed

Tumour Biol. 2014 Feb;35(2):1183-91 PubMed

J Clin Oncol. 2000 Feb;18(4):743-53 PubMed

Am J Epidemiol. 2013 Feb 15;177(4):316-27 PubMed

N Engl J Med. 2005 Jul 21;353(3):275-85 PubMed

Breast Cancer Res. 2013 Jan 15;15(1):R4 PubMed

Adv Nutr. 2012 Nov 01;3(6):755-62 PubMed

Menopause. 2011 Apr;18(4):385-92 PubMed

Cancer Epidemiol Biomarkers Prev. 2014 May;23(5):755-64 PubMed

EPMA J. 2010 Jun;1(2):237-44 PubMed

Cancer. 2003 Jun 1;97(11):2919-25 PubMed

Lancet. 2011 Feb 12;377(9765):557-67 PubMed

Occup Med (Lond). 2011 Mar;61(2):78-89 PubMed

Nat Rev Clin Oncol. 2014 Oct;11(10):597-609 PubMed

World J Gastroenterol. 2015 Jan 28;21(4):1081-90 PubMed

Perm J. 2015 Spring;19(2):48-79 PubMed

Cancer. 2012 Jun 1;118(11):2796-803 PubMed

Cancer Epidemiol Biomarkers Prev. 2010 Mar;19(3):729-37 PubMed

Am J Psychiatry. 2001 Aug;158(8):1252-7 PubMed

Br J Cancer. 2002 Oct 21;87(9):982-8 PubMed

Int J Cancer. 2008 Aug 15;123(4):933-41 PubMed

Am J Geriatr Psychiatry. 2010 May;18(5):442-51 PubMed

Am J Epidemiol. 2010 Jun 1;171(11):1183-94 PubMed

Cancer Causes Control. 2006 May;17(4):531-7 PubMed

Environ Health Perspect. 2017 Feb;125(2):223-229 PubMed

Am J Prev Med. 2004 Aug;27(2 Suppl):25-33 PubMed

J Prosthet Dent. 2016 Jun;115(6):658-61 PubMed

Int J Obes Relat Metab Disord. 2000 Dec;24(12):1628-35 PubMed

BMC Cancer. 2013 May 01;13:219 PubMed

Int J Cancer. 2011 Sep 1;129(5):1214-24 PubMed

Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):485-94 PubMed

World J Clin Oncol. 2014 May 10;5(2):71-81 PubMed

Pediatrics. 2010 May;125(5):e1081-7 PubMed

Breast Cancer Res Treat. 2013 Aug;140(3):587-601 PubMed

Cancer Causes Control. 2014 Sep;25(9):1101-17 PubMed

Psychol Rev. 2005 Apr;112(2):417-45 PubMed

EPMA J. 2013 Sep 16;4(1):22 PubMed

BMJ. 2013 Feb 07;346:f165 PubMed

Cancer Epidemiol Biomarkers Prev. 2005 Dec;14(12):2889-97 PubMed

Cancer Epidemiol Biomarkers Prev. 2009 Jan;18(1):74-9 PubMed

J Interferon Cytokine Res. 2015 Jan;35(1):1-16 PubMed

Acta Paediatr. 1996 Sep;85(9):1083-90 PubMed

Genet Med. 2011 Jan;13(1):52-62 PubMed

Aesthetic Plast Surg. 2013 Apr;37(2):278-89 PubMed

Neuroscience. 2013 Nov 12;252:302-19 PubMed

Cancer. 2016 Jul 15;122(14):2138-49 PubMed

Br J Cancer. 2012 Oct 23;107(9):1608-17 PubMed

J Epidemiol. 2014;24(1):1-6 PubMed

CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90 PubMed

Obes Rev. 2013 Aug;14(8):665-78 PubMed

Curr Oncol Rep. 2009 Nov;11(6):490-6 PubMed

Cancer Epidemiol Biomarkers Prev. 2014 Aug;23(8):1672-6 PubMed

Anticancer Res. 2006 May-Jun;26(3B):2345-8 PubMed

Pediatrics. 2012 May;129(5):e1192-8 PubMed

Lancet. 2011 Aug 27;378(9793):815-25 PubMed

Cancer Causes Control. 2013 May;24(5):919-28 PubMed

Br J Cancer. 2001 Nov 30;85(11):1680-4 PubMed

Breast. 2013 Aug;22 Suppl 2:S30-7 PubMed

Ann Behav Med. 2012 Jun;43(3):402-8 PubMed

Int J Environ Res Public Health. 2015 Dec 09;12(12):15683-91 PubMed

Cancer. 2012 Dec 1;118(23):5929-36 PubMed

Eur J Cancer. 2005 Sep;41(13):2023-32 PubMed

Cancer Epidemiol Biomarkers Prev. 2015 Feb;24(2):361-8 PubMed

J Natl Cancer Inst. 2003 Aug 20;95(16):1218-26 PubMed

Histopathology. 2016 Nov;69(5):890-892 PubMed

Cancer Res. 2010 Mar 15;70(6):2397-405 PubMed

Lancet. 2002 Jul 20;360(9328):187-95 PubMed

J Cancer Res Clin Oncol. 2012 May;138(5):799-809 PubMed

Cancer. 1993 Feb 15;71(4):1258-65 PubMed

J Clin Oncol. 2010 Feb 20;28(6):1005-10 PubMed

Am J Epidemiol. 2013 Dec 15;178(12):1712-20 PubMed

Am J Case Rep. 2015 Sep 15;16:621-6 PubMed

Front Oncol. 2012 Nov 15;2:163 PubMed

Breast Cancer Res. 2008;10(2):R26 PubMed

Alcohol Alcohol. 2012 May-Jun;47(3):204-12 PubMed

J Natl Cancer Inst. 2009 Mar 18;101(6):384-98 PubMed

J Pain Symptom Manage. 2002 Nov;24(5):471-80 PubMed

Arch Intern Med. 2011 Jan 24;171(2):125-33 PubMed

J Natl Cancer Inst. 2001 Oct 17;93(20):1563-8 PubMed

Am J Psychiatry. 2008 Dec;165(12):1543-50 PubMed

Breast Cancer Res Treat. 2014 Jun;145(3):567-79 PubMed

Am J Med Genet C Semin Med Genet. 2014 Mar;166C(1):24-33 PubMed

Am J Hypertens. 1995 Jul;8(7):657-65 PubMed

Radiol Oncol. 2010 Jun;44(2):79-85 PubMed

World J Diabetes. 2014 Jun 15;5(3):372-80 PubMed

Int J Cancer. 2009 Feb 1;124(3):698-712 PubMed

Occup Environ Med. 2003 Nov;60(11):810-4 PubMed

Scand J Work Environ Health. 2014 May 1;40(3):295-304 PubMed

EPMA J. 2013 Feb 19;4(1):6 PubMed

Semin Clin Neuropsychiatry. 2003 Oct;8(4):229-40 PubMed

Epidemiol Rev. 2014;36:114-36 PubMed

J Med Screen. 2011;18(4):163-4 PubMed

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2012 Jan;55(1):10-6 PubMed

Nature. 2015 Jun 4;522(7554):106-110 PubMed

Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1159-69 PubMed

J Gen Intern Med. 2010 Jul;25(7):717-24 PubMed

Int J Epidemiol. 2005 Apr;34(2):405-12 PubMed

Eur J Cancer Prev. 2014 Mar;23(2):134-40 PubMed

Elife. 2013 Dec 31;2:e01926 PubMed

Atherosclerosis. 1994 Dec;111(2):237-46 PubMed

Int J Cancer. 2006 Sep 15;119(6):1403-11 PubMed

Ann Intern Med. 2009 Nov 17;151(10):727-37, W237-42 PubMed

J Natl Cancer Inst. 2012 Apr 4;104(7):517-27 PubMed

BMC Cancer. 2013 Oct 25;13:498 PubMed

Geospat Health. 2016 Apr 18;11(1):320 PubMed

Psychosom Med. 2006 Sep-Oct;68(5):675-83 PubMed

EPMA J. 2014 Jul 08;5(1):11 PubMed

Nat Rev Cancer. 2008 Nov;8(11):887-99 PubMed

Nature. 2002 Dec 19-26;420(6917):860-7 PubMed

J Natl Cancer Inst. 2013 Oct 16;105(20):1571-8 PubMed

N Engl J Med. 1985 Jan 17;312(3):146-51 PubMed

Cancer Metastasis Rev. 2012 Jun;31(1-2):247-68 PubMed

Support Care Cancer. 2006 Mar;14(3):201-9 PubMed

Breast Cancer Res. 2015 Sep 04;17:122 PubMed

Nat Rev Clin Oncol. 2011 Aug 02;8(11):669-76 PubMed

Per Med. 2016 Sep;13(5):469-484 PubMed

Mol Cell Biochem. 2011 Sep;355(1-2):193-9 PubMed

Asia Pac J Public Health. 2013 Sep;25(5):368-87 PubMed

PLoS One. 2013 May 16;8(5):e63165 PubMed

Mod Pathol. 2007 Nov;20(11):1149-55 PubMed

Cancer Lett. 2014 Jan 1;342(1):9-18 PubMed

Br J Cancer. 2013 Jun 11;108(11):2205-40 PubMed

Breast Care (Basel). 2010;5(6):389-394 PubMed

Cancer Lett. 2006 Feb 20;233(1):98-107 PubMed

EPMA J. 2014 May 30;5(1):8 PubMed

BMJ Open. 2014 Jul 03;4(7):e005245 PubMed

Health Aff (Millwood). 2009 Sep-Oct;28(5):w822-31 PubMed

Cancer Causes Control. 2014 Aug;25(8):945-57 PubMed

Soc Sci Med. 2013 Jul;89:53-61 PubMed

Endocr Relat Cancer. 2014 Aug;21(4):629-38 PubMed

Am J Ind Med. 2015 Mar;58(3):252-66 PubMed

Scand J Work Environ Health. 2010 Mar;36(2):163-79 PubMed

J Natl Cancer Inst. 2009 May 6;101(9):630-43 PubMed

J Steroid Biochem Mol Biol. 2014 Sep;143:207-22 PubMed

Biomark Res. 2015 Sep 04;3:24 PubMed

Cancer Causes Control. 2013 Jan;24(1):81-9 PubMed

Environ Int. 2016 Apr-May;89-90:185-92 PubMed

Cancer Epidemiol Biomarkers Prev. 2009 Jul;18(7):2030-4 PubMed

Brain Behav Immun. 2013 Mar;30 Suppl:S58-67 PubMed

BMC Cancer. 2014 Jan 29;14:47 PubMed

J Breast Cancer. 2011 Sep;14(3):229-36 PubMed

Cancer Res. 2005 Oct 15;65(20):9595-600 PubMed

Gynecol Obstet Fertil. 2013 Feb;41(2):105-9 PubMed

Int J Cancer. 2014 Feb 1;134(3):629-44 PubMed

Int J Cancer. 2007 Aug 1;121(3):645-8 PubMed

Endocr Relat Cancer. 2013 Nov 04;20(6):875-87 PubMed

J Natl Cancer Inst Monogr. 2004;(32):40-50 PubMed

Breast Cancer Res. 2014 Sep 28;16(5):446 PubMed

Med Hypotheses. 2011 Sep;77(3):430-6 PubMed

Cell. 2010 Mar 19;140(6):883-99 PubMed

Int J Cancer. 2011 Jan 1;128(1):144-56 PubMed

Ann Epidemiol. 2014 May;24(5):376-82 PubMed

Can J Cardiol. 1999 Dec;15 Suppl G:1G-119G PubMed

Integr Cancer Ther. 2009 Dec;8(4):387-97 PubMed

Cell Biochem Biophys. 2014 Mar;68(2):397-406 PubMed

Contemp Oncol (Pozn). 2016;20(1):13-9 PubMed

EPMA J. 2010 Jun;1(2):263-72 PubMed

Hered Cancer Clin Pract. 2014 Feb 21;12(1):2 PubMed

Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3116-22 PubMed

Ann Oncol. 2014 Oct;25(10):1901-14 PubMed

Prostate cancer management: long-term beliefs, epidemic developments in the early twenty-first century and 3PM dimensional solutions

Genoprotective activities of plant natural substances in cancer and chemopreventive strategies in the context of 3P medicine

Chemopreventive and Therapeutic Efficacy of Cinnamomum zeylanicum L. Bark in Experimental Breast Carcinoma: Mechanistic In Vivo and In Vitro Analyses

Anticancer Activities of Thymus vulgaris L. in Experimental Breast Carcinoma in Vivo and in Vitro

Liquid biopsy and multiparametric analysis in management of liver malignancies: new concepts of the patient stratification and prognostic approach

Pregnancy-associated breast cancer: the risky status quo and new concepts of predictive medicine

Breast cancer and Flammer syndrome: any symptoms in common for prediction, prevention and personalised medical approach?

"Pre-metastatic niches" in breast cancer: are they created by or prior to the tumour onset? "Flammer Syndrome" relevance to address the question

Mystery of the brain metastatic disease in breast cancer patients: improved patient stratification, disease prediction and targeted prevention on the horizon?

Postmenopausal breast cancer: European challenge and innovative concepts