PEMBROKE PARK, Fla. -

Breast cancer is the second leading cause of cancer death in women after lung cancer, and many don't realize that smoking increases their risk of developing the disease.

"Women need to be aware of the behavioral factors, including smoking, that can lead to breast cancer," said Dr. Cassann Blake, a breast specialist with the Cleveland Clinic Florida. "High alcohol intake has also been associated with a risk of developing breast cancer."

Among the greatest preventive measures, Blake said vigorous physical activity starting in a woman's teenage years is showing a strong protective effect.

"Committing to a vigorous physical activity plan can help reduce the risk of developing breast cancer by anywhere from 20 to 80 percent," Blake said.

As far as screening, Blake said annual mammograms starting at the age of 40 are the gold standard.

?Women with first- or second-degree relatives who were diagnosed with breast cancer under the age of 50 may benefit from getting annual mammograms at an earlier age," she said.

Blake said digital mammography has shown the greatest benefit in premenopausal women and women with dense breast tissue.

"This information comes from a study involving over 10,000 women. The other benefit is the portability of digital mammograms," said Blake.

To learn more about your individual risk for developing breast cancer, go to the federal government's cancer website and search for the Gail breast cancer risk model.