One of the most important things we can do to improve the survival rate for breast cancer is to find it early, or maybe even prevent it in the first place. Much has been learned about the genetic and environmental influences on the risk of getting breast cancer. Knowing your risk is an important first step in determining screening and prevention strategies.
Genetic risk comes from inherited mutations (damaged genes) from the Mother or Father. Hereditary Cancer Syndromes can now be identified with widely available panel testing and insurance is mandated to cover testing in appropriate cases. Results of these tests can significantly affect the risk of breast, ovarian, uterine, colon and other cancers. We are primarily concerned about the potential for mutations when there is a family history of cancer in multiple generations or a young age (<45) at diagnosis. If you’re concerned about your family history, speak with your physician and request a referral to a genetic counselor. Many insurances offer virtual counseling and testing can be done via the mail.
Environmental influences likely account for 70% of new breast cancers. Risk factors include starting periods early or late menopause, having your first child after 30 or not having children at all, obesity, smoking, high animal fat diet and alcohol use. Use of combination (estrogen and progesterone) hormone replacement after menopause for more than 5 years has also been shown to increase the risk of getting breast cancer by 1.5X, but not of dying of breast cancer.
Multiple risk factor estimate nomograms are available. These combine family history and environmental factors. These can be done on-line, at Breast Care Centers, and in your doctor’s office. It’s important to realize these are based on large populations, and not individuals. A lifetime risk of over 20-25% is considered above normal, and may indicate additional screening could be helpful.
For more information, or to assess your risk, go to the following links:
To see all cancer screening recommendations go to:
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