My husband and I don't want to have any more children, and I am considering a tubal ligation. I have heard that this could cause an increase in the chance of getting breast cancer. Is this true? Also, I am concerned because my mom has breast cancer.

--Kathy

There is absolutely no evidence in the scientific literature to suggest an association between tubal ligation and subsequent breast cancer risk. The only studies on tubal ligation and cancer that I could find relate to ovarian cancer; these actually show a very slight decrease in the risk of certain types of ovarian cancer in women who have had their tubes tied.

Risk factors for developing breast cancer include the following:

• Family history. If your mother had breast cancer, especially if it developed before she was in menopause, your risk is increased by two to three times.
  
• Age. The risk of breast cancer increases with age. According to figures from the National Cancer Institute (1993 data), a 40-year-old woman has a 1-in-220 chance of having breast cancer. At age 50, the risk is 1 in 50; at age 60, it's 1 in 24; at age 70, it's 1 in 14; and at age 80, it's 1 in 10. Among women who live into their nineties, one out of eight will have breast cancer.
  
• Number of children and age at first birth. Women who have never had a child have an increased risk of breast cancer. The younger you are when your first child is born, the lower your risk of breast cancer. Breastfeeding also confers some protection against subsequent breast cancer.
  
• Age at first menses. The younger you are when menstrual periods begin, the higher your risk. The later you enter menopause, the higher the risk as well. This is due to the longer period of time that naturally occurring estrogen is present in your body. This risk can be mitigated somewhat by age at first childbirth and number of pregnancies.
  
• Alcohol. Consistent moderate intake of alcohol (two or more drinks daily) is associated with increased risk of breast cancer risk.
  
• Cigarette smoking. Cigarettes are evil. Enough said.
  

To reduce your risk of breast cancer, eat a healthy diet high in fiber and vegetables (especially things like broccoli and cauliflower), exercise regularly, maintain a normal body weight, DO NOT SMOKE, drink alcohol in moderation if at all, and breastfeed any children you may have. Also, perform monthly breast self-examinations and begin to have mammograms at age 40 or five years earlier than your mother's breast cancer was detected, whichever comes first.