Genetic susceptibility genes are not the same as genetic diseases. The concept of “genetic diseases” often leads to different opinions among social groups, which in turn leads to a series of problems. Behind this series of problems is the neglect of the concept of “polygenic genetic disorders”. Unlike conventional single-gene diseases such as red-green color blindness and albinism, polygenic diseases are those that involve multiple genes, each of which is only minimally cumulative, so the severity of the disease and the risk of recurrence can vary significantly from person to person depending on the number of genes that may be involved. The higher the number and the more advanced the causative genes, the higher the risk of developing the disease and the more severe it is. How do these disease-causing genes add up to so many “abnormalities”? One is the inheritance of abnormal genes from parents, and the other is an acquired stage mutation. It is worth mentioning that so many genes together determine a disease, it seems very difficult to rely entirely on parental genes to decide, so relatively speaking, acquired factors become very important. In general, the more genes involved in a disease that play a role, the greater the component of acquired influence. For example, hypertension, diabetes, breast cancer, etc., are all polygenic genetic diseases. As an example, height is controlled by multiple genes. The height of the parents is often used clinically to estimate the “normal” height of the child, reflecting the fact that the height of the parents can greatly influence the height of the child. In fact, with the influence of nutrition and exercise, children’s height does not exactly follow the formula, which is an acquired effect. The risk factors for breast cancer breast cancer is a similar truth. In the 1990s, scientists identified two genes directly related to hereditary breast cancer, named breast cancer gene 1 and 2, or BRCAl/BRCA2 for short, and if the structure of the BRCAl/BRCA2 gene is mutated, then the carriers of the mutated gene are prone to breast or ovarian cancer. It has been shown that more than 80% of BRCA1/BRCA2 mutation carriers will develop breast cancer. Currently there are 40 genes associated with breast cancer. Breast cancer is also divided into many types, each with a different genetic background. In addition to genetics, there are many acquired factors that play a role. These include estrogen levels, weight, fertility, birth control pills, smoking and alcohol. For example, overweight people secrete estrogen from fat cells, which is positively correlated with the development of breast cancer; fertile women have more adequate progesterone protection, which can reduce the risk of estrogen-stimulated breast cancer to some extent. In addition, young age of menarche, late menopause and short menstrual cycle are high risk factors for breast cancer. The incidence of lifelong infertility, age at first birth older than 30 years, and failure to breastfeed after childbirth are higher. Combined estrogen and progestin replacement therapy after menopause slightly increases the risk of invasive breast cancer, while the use of estrogen marginally decreases this risk. Those who are overexposed to ionizing radiation have a higher risk of developing cancer. In summary, genetic factors play a role in the development of breast cancer, but acquired environmental factors should not be ignored. A family history of breast cancer does not mean you will develop breast cancer, but your risk of developing the disease is higher than those without a family history. If a mother develops breast cancer before menopause (immediate family history), her daughter is twice as likely to develop breast cancer, and the age of the disease may also be earlier. Therefore, women with a family history of breast cancer should be screened regularly for early detection. The same does not mean that you will not develop breast cancer if you do not have a family history. The accumulation of environmental factors can also trigger the development of breast cancer at a certain level. But for a certain individual, statistics often seem powerless, it happens if it happens, it doesn’t happen if it doesn’t happen, but it doesn’t mean it won’t happen in the future. So like Jolie, one does not want to top the risk of greater than 80% and thus choose mastectomy on her own. So the emphasis is on prevention, especially in diet, weight, and endocrine efforts. Early detection and treatment is possible to achieve breast conservation and reconstruction with a better prognosis.