WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Dr. Nadia Tareq Zaidan, Dr. Amina Mamon Akram Alsawaf, Dr. Amar H. Yehia

ABSTRACT

Background: Breast cancer is the most frequently diagnosed malignancy and a leading cause of cancer-related mortality among women worldwide. Its burden is increasing, particularly in low- and middle-income countries, including Iraq. The disease is multifactorial, with contributions from hormonal, reproductive, genetic, and lifestyle-related factors. However, locally generated data on risk factors in Mosul remain limited. Objectives: To identify and evaluate the risk factors associated with breast cancer among women attending breast clinics in Mosul. Methods: A hospital-based case–control study was conducted from May 1, 2025, to February 1, 2026, at Al-Jamhory and Al-Khansaa Teaching Hospitals in Mosul. The study included 200 women (100 cases with breast cancer and 100 controls). Data were collected using a structured questionnaire covering demographic, reproductive, menstrual, lifestyle, and hormonal factors. Statistical analysis was performed using SPSS version 26. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and a p-value ≤0.05 was considered statistically significant. Results: Advanced age (≥65 years) was significantly associated with increased breast cancer risk (OR=5.26, p=0.005). Early menarche (<12 years) (OR=6.38, p=0.0001), late menopause (≥50 years) (OR=2.89, p=0.02), and prolonged reproductive lifespan (>30 years) (OR=5.30, p=0.0001) were significant hormonal risk factors. Delayed age at first full-term pregnancy (≥30 years) markedly increased risk (OR=9.52, p=0.0001), while early pregnancy (<20 years) showed a protective effect. Short duration of breastfeeding (<6 months) was associated with increased risk (OR=4.00, p=0.0001), whereas longer duration was protective. Obesity (BMI 30–39.9) significantly increased risk (OR=2.93, p=0.0001), while normal BMI was protective. Passive smoking was also significantly associated with increased risk (OR=2.19, p=0.02). Prolonged use of oral contraceptive pills (>3 years) increased risk (OR=4.16, p=0.013). No significant association was found with marital status, residence, parity, abortion history, family history, or hormonal therapy. Conclusions: Breast cancer risk among women in Mosul is strongly influenced by hormonal and reproductive factors, as well as modifiable lifestyle factors such as obesity and passive smoking. Preventive strategies focusing on lifestyle modification, reproductive health awareness, and early detection are essential to reduce the burden of the disease.

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