While everyone has some inherent risk of developing breast cancer, certain individuals face a significantly higher risk than others. The good news is that understanding your personal risk profile is the first step toward taking early, preventative action.
Assessing Your Risk
The initial step is to take an in-depth look at your family history.
- Family History: This includes any relatives diagnosed with breast cancer, especially first-degree relatives (parent, sibling, child). Also include the age of diagnosis and if they had cancer in both breasts.
- Genetic Factors: Some people inherit genetic mutations, such as BRCA1 and BRCA2, that put them at a much higher risk.
"An initial screening can be done with your primary care or OB/GYN provider," says Dr. Jessica Henderson, a breast surgeon at McLaren Greater Lansing Comprehensive Breast Care Clinic. "You'll discuss individual factors that contribute to your risk."
These personal factors include, but are not limited to:
- The age of your first menstrual period
- Whether you are post-menopausal
- The age of your first live birth, or if you've given birth
- Use of birth control or hormone replacement therapy after menopause
- Breast density
Dr. Henderson also uses formal risk assessment tools, such as the Tyrer-Cuzick calculator or the Gail Model, to estimate risk based on a percentage.
Recommendations for prevention vary based on your risk level.
Average Risk
For those in the low to moderate risk categories, your doctor may recommend standard screening measures and lifestyle changes.
- Screenings: Standard screenings may include a combination of mammograms and physical breast exams. For women with high breast density, supplemental screening with breast ultrasound may be indicated.
- Lifestyle: Adopt a healthy diet, such as the Mediterranean diet—rich in fruits, vegetables, lean protein, and fish—while limiting red meat and avoiding processed foods. Exercising for just 30 minutes a day, five days a week, can also significantly improve your overall health.
High Risk
In addition to standard screenings and lifestyle changes, women with increased risk of breast cancer may benefit from advanced screening measures.
- For high-risk patients, screening may include an annual mammogram and an annual breast MRI. These screenings are often done interchangeably, every six months, for comprehensive coverage.
Individuals with a very high risk may qualify for additional interventions, including medication or surgery.
- Medication: Drugs like tamoxifen can be prescribed, which helps block the effects of estrogen in certain tissues, such as breast tissue.
- Prophylactic Mastectomy: A preventative surgical procedure is also an option for moderate- to high-risk patients.
"Bilateral mastectomies can reduce the risk by 98%," says Dr. Henderson. "Whether a patient has a strong family history or carries a genetic mutation, this can be the best risk-reduction option for certain patients."
There are a few surgical options available, including a simple mastectomy (in which the nipple and areola are removed) or a skin-sparing mastectomy, or a nipple-sparing mastectomy. Your surgeon will discuss the best approach for you.
Next Steps
Dr. Henderson recommends beginning at the age of 25 to consider having a risk assessment and to take action sooner than later. You can find several risk assessments online, or your primary care provider or OB/GYN can complete one with you.
For more information on the Comprehensive Breast Clinic at McLaren Greater Lansing, click here.
Karmanos Cancer Institute at McLaren Greater Lansing also offers genetic counseling services virtually or in person. If you are interested in learning more about your personal cancer risks through genetic testing, click here.
To schedule a mammogram, click here.
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