Ana Maria Gonzalez-Angulo, MD, PhD, is a medical oncologist, researcher, and former tenured professor at the University of Texas MD Anderson Cancer Center. Her academic and clinical work has focused on breast cancer, including HER2-positive disease, Triple-Negative Breast Cancer, minimal residual disease, molecular diagnostics, and treatment resistance. She currently serves as Medical Director of Research and Senior Medical Oncologist at Consultores de Oncologia and as a senior medical oncologist at Unidad de Cancerologia, both in Guadalajara, Mexico. Through leadership in clinical research, systems biology, and international academic collaborations, Dr. Gonzalez-Angulo has contributed to a broader understanding of the biological and environmental factors that influence breast cancer. Her experience in patient care, education, and translational research provides a relevant foundation for examining breast cancer risk factors and the importance of informed screening discussions.
Breast cancer is a disease characterized by abnormal cellular growth in breast tissue. Breast cancer ranks only behind skin cancer as the most common cancer diagnosis for women in the United States, though men can also develop the disease. Despite the widespread prevalence of breast cancer, technological advances and ongoing research have resulted in increasing survival rates, earlier diagnoses, and numerous life-extending treatments in cases where cures are not possible. Additional breakthroughs facilitated by national breast cancer awareness and funding for research have made it easier for health care providers to create effective treatment plans.
Despite these and other advances, the cause of breast cancer often remains a mystery to doctors. Decades of research and clinical studies have provided physicians with information about risk factors for breast cancer, including lifestyle choices, hormones, and environmental factors. Yet, many breast cancer patients have no history of these risk factors, and individuals who rank as high-risk candidates for breast cancer do not always develop the disease. Doctors believe that the disease pathology likely involves a complex series of genetic interactions and environmental influences.
Breast cancer begins when something changes within the cells that comprise a person’s breast tissue. This DNA is critical for relaying important instructions to cells and governing cellular behavior. Healthy cells use these instructions to grow and multiply at a healthy rate. The instructions even inform cells when it is time to cease functioning and die. But the change associated with breast cancer modifies these instructions, directing cells to produce more cells at an accelerated rate. In addition to rapid multiplication, cancerous cells continue living when normal cells would die, further increasing the number of abnormal cells in the breast tissue.
As cells grow and multiply, they often come together and form a mass called a tumor. As the malignant tumor expands, it further damages healthy breast tissue. The longer cancer cells reproduce in breast tissue, the greater the risk that they will break away and start spreading to other regions of the body through a process called metastasis.
Research has revealed that the DNA alterations that cause breast cancer usually happen in cells lining the milk ducts, tubes that transport milk to the nipple. Breast cancer that begins in the ducts is known as invasive ductal carcinoma, though cancer originating in the milk glands, called invasive lobular carcinoma, is also common.
Known risk factors that increase a person’s chances of developing breast cancer include starting their period before the age of 12 or menopause after the age of 55, having dense breast tissue, the consumption of alcohol, obesity, and radiation exposure. Pregnancy is a complex risk factor for breast cancer, as pregnancy after the age of 30 and never giving birth can both increase a person’s breast cancer risk. Any person who has had breast cancer has an increased risk of developing the disease again. Similarly, a family history of breast cancer and a personal history of other breast conditions influence risk.
Doctors also believe that certain inherited DNA changes can influence a person’s cancer risk. BRCA1 and BRCA2 DNA changes are especially influential when it comes to the risk of not just breast cancer, but several other forms of the disease. Yet, these changes do not always lead to cancer, compelling scientists and medical researchers to dedicate more time to understanding the disease mechanism.
Limiting or eliminating alcohol consumption can somewhat mitigate breast cancer risk. Exercising daily and taking a strategic approach to menopausal hormone theory can also lower a person’s cancer risk. All women, especially those with a family history of cancer, should ask their doctors about breast screening and how to perform effective self-exams.
About Ana Maria Gonzalez-Angulo
Ana Maria Gonzalez-Angulo, MD, PhD, is a medical oncologist and breast cancer researcher based in Guadalajara, Mexico. She previously served as a tenured professor at MD Anderson Cancer Center, where she worked in breast medical oncology and systems biology. Her research has addressed aggressive breast cancer, treatment resistance, translational genomics, and molecular diagnostics. She has published extensively and contributed to organizations including the Translational Breast Cancer Research Consortium, the Cancer Genome Atlas Breast Working Group, SWOG, and the Breast International Group-North American Breast Group.
