Factors Associated with Breast Cancer Risk in Women: A Literature Review

• A.E. Anichkova

  Department of Oncology and Clinical Morphology, Bashkir State Medical University, Ufa, Russian Federation

• Sh.R. Kzyrgalin

  Department of Oncology and Clinical Morphology, Bashkir State Medical University, Ufa, Russian Federation

• R.Sh. Khasanov

  Kazan State Medical Academy, Kazan, Russian Federation

• Sh.Kh. Gantsev

  Department of Oncology and Clinical Morphology, Bashkir State Medical University, Ufa, Russian Federation

Breast cancer is a disease with a multifactorial etiology shaped by genetic, hormonal, reproductive, phenotypic, environmental, and socio-behavioral determinants. This narrative review with a systematic search strategy aimed to systematize factors associated with breast cancer risk and incidence, with an emphasis on their applicability in risk-oriented early detection models. The literature search was conducted in PubMed/MEDLINE, Scopus, eLIBRARY.ru, and additional sources for the period from 19 December 2020 to 19 December 2025. The review included narrative reviews, systematic reviews, and meta-analyses, as well as a limited number of original studies meeting predefined eligibility criteria (Population, Exposure, Outcome, and Study design). The final corpus comprised 48 publications. Risk factors were grouped into thematic domains and qualitatively classified according to the degree of epidemiological consistency and suitability for inclusion in individual risk models (categories A–C). The most robust associations were identified for age, mammographic density, hereditary and family history, several hormonal and reproductive characteristics, smoking, and night shift work. For environmental exposures, obesity, and certain chemical factors, the evidence base was characterized by greater heterogeneity, whereas for psychoemotional factors and radiofrequency electromagnetic fields it remained limited and should be considered hypothesis-generating. This review demonstrates the uneven quality and consistency of contemporary evidence on breast cancer risk factors and highlights the need for their critical interpretation within risk-oriented approaches. The resulting list of candidate factors may serve as a basis for predictor selection and subsequent prospective validation in the development of individual risk models aimed at optimizing early diagnosis.

[1] Wang Y, et al. Detection of cancers three years prior to diagnosis using plasma cell-free DNA. Cancer Discov 2025.

[2] Kzyrgalin ShR, Gantsev KSh, Rizvanov AA, Gantsev ShKh. New insight of oncology: cancer concept without tumor. J Cancer Res Updates 2024; 13: 6-11.

[3] Gantsev ShKh, Kzyrgalin ShR, Gantsev KSh, et al. Rak bez opukholi: peresechenie kontseptsiy. Palliat med reabil 2025; (3): 10-14.

[4] Pavlova NV, Demin SS, Churnosov MI, Ponomarenko IV. Sovremennyy vzglyad na rol geneticheskikh faktorov v etiopatogeneze raka molochnoy zhelezy. Usp mol onkol 2024; 11(2): 50-62.

[5] Obeagu EI, Obeagu GU. Breast cancer: a review of risk factors and diagnosis. Medicine (Baltimore) 2024; 103(3): e36905.

[6] Joyce R, Visvader JE. Cells-of-origin of breast cancer and intertumoral heterogeneity. Adv Exp Med Biol 2025; 1464: 151-165.

[7] Islam MS, Jesmin. Association of hypoxia-inducible factor 1α gene polymorphisms with breast cancer susceptibility: a meta-analysis. JCO Glob Oncol 2022; 8: e2100399.

[8] Dastgheib SA, Sayad S, Azizi S, Hajizadeh N, Asadian F, Karimi-Zarchi M, et al. Association between XRCC2 Arg188His polymorphism and breast cancer susceptibility: a systematic review and meta-analysis. Asian Pac J Cancer Prev 2024; 25(1): 43-55.

[9] Alijanpour A, Golshan A, Vakili-Ojarood M, Shirinzadeh-Dastgiri A, Naseri A, Karimi-Zarchi M, et al. Association of the CXCL12 rs1801157 polymorphism with breast cancer risk: a meta-analysis. Asian Pac J Cancer Prev 2024; 25(3): 767-776.

[10] Tikhonov DG, Molokov AYu, Belyavskaya VA, Ananina OA, Gervas PA. Endogennye i ekzogennye faktory riska, vliyayushchie na uroven zabolevaemosti naseleniya Yakutii rakom molochnoy zhelezy. Sib onkol zhurn [Internet] 2023; (3) [cited 2025 Dec 4]. Available from: CyberLeninka.

[11] Coelingh Bennink HJT, Schultz IJ, Schmidt M, Jordan VC, Briggs P, Egberts JFM, et al. Progesterone from ovulatory menstrual cycles is an important cause of breast cancer. Breast Cancer Res 2023; 25(1): 60.

[12] Li C, Fan Z, Lin X, Cao M, Song F, Song F. Parity and risk of developing breast cancer according to tumor subtype: a systematic review and meta-analysis. Cancer Epidemiol 2021; 75: 102050.

[13] Ye DM, Bai X, Xu S, Qu N, Zhao N, Zheng Y, et al. Association between breastfeeding, mammographic density, and breast cancer risk: a review. Int Breastfeed J 2024; 19(1): 65.

[14] Shertaeva AB, Ospanova DA, Grzhibovskiy AM. Faktory riska razvitiya raka molochnoy zhelezy. Nauka zdravookhr [Internet] 2022; (2) [cited 2025 Dec 4]. Available from: CyberLeninka.

[15] Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast cancer—epidemiology, risk factors, classification, prognostic markers, and current treatment strategies—an updated review. Cancers (Basel) 2021; 13(17): 4287.

[16] Sayon-Orea C, Romanos-Nanclares A, Bullón-Vela V, Chiva-San Roman I, Caiado B, Ondarra-Erdozain M, et al. Effect of duration of hormonal contraceptive use on breast cancer risk: a systematic review and meta-analysis of cohort studies. Maturitas 2025; 202: 108750.

[17] Rozenberg S, Di Pietrantonio V, Vandromme J, Gilles C. Menopausal hormone therapy and breast cancer risk. Best Pract Res Clin Endocrinol Metab 2021; 35(6): 101577.

[18] Zürcher A, Knabben L, Janka H, Stute P. Influence of the levonorgestrel-releasing intrauterine system on the risk of breast cancer: a systematic review. Arch Gynecol Obstet 2023; 307(6): 1747-1761.

[19] Chlebowski RT, Aragaki AK, Pan K, Mortimer JE, Johnson KC, Wactawski-Wende J, et al. Randomized trials of estrogen-alone and breast cancer incidence: a meta-analysis. Breast Cancer Res Treat 2024; 206(1): 177-184.

[20] Calaf GM, Ponce-Cusi R, Aguayo F, Muñoz JP, Bleak TC. Endocrine disruptors from the environment affecting breast cancer. Oncol Lett 2020; 20: 19-32.

[21] Bai S, Song D, Chen M, Lai X, Xu J, Dong F. The association between mammographic density and breast cancer risk in Chinese women: a systematic review and meta-analysis. BMC Womens Health 2024; 24(1): 131.

[22] Bodewes FTH, van Asselt AA, Dorrius MD, Greuter MJW, de Bock GH. Mammographic breast density and the risk of breast cancer: a systematic review and meta-analysis. Breast 2022; 66: 62-68.

[23] Burke A, O’Driscoll J, Abubakar M, et al. A systematic review of determinants of breast cancer risk among women with benign breast disease. npj Breast Cancer 2025; 11: 16.

[24] Lichtiger L, Rivera J, Sahay D, Miller RL. Polycyclic aromatic hydrocarbons and mammary cancer risk: does obesity matter too? J Cancer Immunol (Wilmington) 2021; 3(3): 154-162.

[25] Darbre PD. Endocrine disrupting chemicals and breast cancer cells. Adv Pharmacol 2021; 92: 485-520. doi: 10.1016/bs.apha.2021.04.006.

[26] Mughees M, Chugh H, Wajid S. Mechanism of phthalate esters in the progression and development of breast cancer. Drug Chem Toxicol 2022; 45(3): 1021-1025.

[27] Tiburcio D, Parsell M, Shapiro H, Adolphe S, Naranjo O, George S, et al. Endocrine disruption to metastasis: how phthalates promote breast carcinogenesis. Ecotoxicol Environ Saf 2025; 303: 118874.

[28] Liu G, Cai W, Liu H, Jiang H, Bi Y, Wang H. The association of bisphenol A and phthalates with risk of breast cancer: a meta-analysis. Int J Environ Res Public Health 2021; 18(5): 2375.

[29] Tippila J, Wah NLS, Akbar KA, Bhummaphan N, Wongsasuluk P, Kallawicha K. Ambient air pollution exposure and breast cancer risk worldwide: a systematic review of longitudinal studies. Int J Environ Res Public Health 2024; 21(12): 1713.

[30] Gabet S, Lemarchand C, Guénel P, Slama R. Breast cancer risk in association with atmospheric pollution exposure: a meta-analysis of effect estimates followed by a health impact assessment. Environ Health Perspect 2021; 129(5): 57012.

[31] Wang R, Wang P, Zhou Y, Wang Y, Xu C, Wang Z, et al. Association between long-term ambient air pollution exposure and the incidence of breast cancer: a meta-analysis based on updated evidence. Ecotoxicol Environ Saf 2025; 289: 117472.

[32] Moslehi R, Stagnar C, Srinivasan S, Radziszowski P, Carpenter DO. The possible role of arsenic and gene-arsenic interactions in susceptibility to breast cancer: a systematic review. Rev Environ Health 2020; 36(4): 523-534.

[33] Koval LE, Hsiao YC, Jiang E, et al. Environmental factors influencing hormone receptor positive breast cancer incidence: integrating chemical signatures from dust wipes with self-reported sources of exposure. J Expo Sci Environ Epidemiol 2025.

[34] Gantsev ShKh, Rakhmatullina IR, Frolova VYu, et al. Vliyanie geologicheskikh formatsiy na sostoyanie zdorovya naseleniya. Vestn Akad Nauk Resp Bashkortostan 2024; 51(2): 43-53.

[35] Rakhmatullina IR, Sultanova RR, Bayturina RR, Balykina AE. Ekologicheskoe znachenie landshafta territoriy v profilaktike onkologicheskikh zabolevaniy. Kreat khir onkol 2025; 15(3): 259-265.

[36] Martello Cristófalo M, Reis YN, Maesaka JY, Mota BS, Soares Júnior JM, Baracat ECF, et al. Occupational exposure to ionizing radiation in female physicians and breast cancer risk: a systematic review and meta-analysis. Clin Breast Cancer 2025.

[37] Wei F, Chen W, Lin X. Night-shift work, breast cancer incidence, and all-cause mortality: an updated meta-analysis of prospective cohort studies. Sleep Breath 2022; 26(4): 1509-1526.

[38] Scala M, Bosetti C, Bagnardi V, Possenti I, Specchia C, Gallus S, et al. Dose-response relationships between cigarette smoking and breast cancer risk: a systematic review and meta-analysis. J Epidemiol 2023; 33(12): 640-648.

[39] Possenti I, Scala M, Carreras G, et al. Exposure to second-hand smoke and breast cancer risk in non-smoking women: a comprehensive systematic review and meta-analysis. Br J Cancer 2024; 131(7): 1116-1125.

[40] Wada K, Nagata C, Utada M, Sakata R, Kimura T, Tamakoshi A, et al. Active and passive smoking and breast cancer in Japan: a pooled analysis of nine population-based cohort studies. Int J Epidemiol 2024; 53(3): dyae047.

[41] Lamchabbek N, Elattabi C, Bour A, et al. Associations between dietary factors and breast cancer risk: a systematic review of evidence from the MENA region. Nutrients 2025; 17(3): 394.

[42] Karimi M, Rabiee R, Hooshmand F, et al. Consumption of fast foods and ultra-processed foods and breast cancer risk: a systematic review and meta-analysis. Glob Health Res Policy 2025; 10(1): 25.

[43] Hanusek K, Karczmarski J, Litwiniuk A, et al. Obesity as a risk factor for breast cancer—the role of miRNA. Int J Mol Sci 2022; 23(24): 15683.

[44] Ermolitskaya MZ, Kiku PF, Abakumov AI. Model otsenki vliyaniya pokazateley kachestva zhizni na zabolevaemost rakom molochnoy zhelezy. Zdravookhr Ross Fed 2024; 68(2): 116-122.

[45] Tsiring DA, Pakhomova YaN, Ponomareva IV, Sergienko ES, Vazhenin AV, Mironchenko MN. The psychological and environment risk factors of development of breast cancer in women residing in industrial megalopolis and rural locality. Probl sots gig zdravookhr ist med 2023; 31(1): 65-71.

[46] Li X, Shen X, Jiang W, Xi Y, Li S. Comprehensive review of emerging contaminants: detection technologies, environmental impact, and management strategies. Ecotoxicol Environ Saf 2024; 278: 116420.

[47] Scientific Committee on Health, Environmental and Emerging Risks (SCHEER). Final opinion on the need of a revision of the annexes in Council Recommendation 1999/519/EC and Directive 2013/35/EU in view of the latest scientific evidence available with regard to radiofrequency (100 kHz–300 GHz) 2023.

[48] Galicia Pacheco SI, Petrova D, Garrido D, Catena A, Madrid Pérez-Esparza B, Torralba C, et al. The relationship between psychological stress and cancer incidence: a systematic review and meta-analysis. Health Psychol Rev 2025.

• PDF

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.