All of the following are predisposing factors for breast carcinoma except: September 2008

Ans. B: First child at a younger age Risk factors for the development of invasive breast cancer include: Female gender: The incidence of breast cancer in women exceeds that in men. Age: Risk increases with age between the third and eighth decades. Age at bih of first child: If aged 30 years or older, relative risk is 2 times that of patients who gave bih when younger than 20 years.So first child at early age is protective. Nulliparous women is more prone for breast carcinoma. Personal history of breast cancer: This factor depends on patient age at time of diagnosis. Risk is increased for younger women. Noninvasive carcinoma (ductal carcinoma in situ (DCIS)/lobular carcinoma in situ (LCIS)) on previous biopsy: This also is a marker for development of invasive lesions. Benign proliferative changes with atypical hyperplasia: These may increase relative risk by 4 times. Early menarche and late menopause: These also are associated weakly with increased relative risk of breast cancer. Menopausal hormone replacement therapy: the combination use of estrogen with progestin has been associated with an greater risk of breast cancer, paicularly of lobular carcinoma. Increased risk is also related to increased duration of use; this risk can be reduced over time, following the termination of hormone replacement therapy. Family history: Degree of relativity of the family member with breast cancer affects individual risk. Genetic predisposition: Approximately 5-10% of breast cancer cases are primarily attributable to inherited factors. The risk of breast cancer in carriers of BRCA1 mutation is estimated to be 36-87%.