May 25, 2017

More options exist today for determining breast cancer risk and what to do next.

Do you know what it means to be at “high” or “elevated” risk for developing breast cancer? Do you know if you are at high risk?

A woman’s lifetime risk of developing breast cancer is approximately 1 in 8. The strongest risk factor is age, according to the National Cancer Institute—that is, your risk increases as you get older.

However, there are other factors that can raise risk, too.

Know breast cancer risk factors tied to family history

Certain gene mutations that are linked to breast cancer, including BRCA1 and BRCA2, are fairly well-known risk factors, as is a family history of breast cancer—especially if the relative with breast cancer is a close relative or was young when diagnosed. You’re also at elevated risk for developing breast cancer again if you’ve already had it in the past.

Other breast cancer risk factors

  • Your ethnicity. White women are at slightly higher risk than African-American women, except in women under age 45.
  • High density breasts. High breast density put you at slightly higher risk than average breast density.
  • Certain benign breast conditions. Some non-cancerous breast conditions, such as atypical ductal hyperplasia and atypical lobular hyperplasia, can raise your risk, especially if you have a family history of breast cancer.
  • Lobular carcinoma in situ. Abnormal cells grow in the milk-producing glands, which can significantly raise your risk of developing invasive breast cancer later.

Today, there are more options available to help determine breast cancer risk, including genetic testing. Genetics referrals can be used to tailor screening for women, taking into account family history and other factors.

Vanderbilt’s Georgia Wiesner, M.D., encourages women to understand their risk profiles. When you know your breast cancer risk profile, you can plan ahead and reduce the odds of developing cancer.

Women at high risk can plan to undergo certain types of screening; for example, a physical exam of breast tissue at least twice each year might be in order. Your healthcare team might plan to alternate a mammogram with a breast MRI every six months, although the exact plan would need to be tailored to fit your individual profile, Wiesner said.

In some cases, certain treatment options to lower your breast cancer risk may be deemed appropriate. This might include chemoprevention, a treatment method involving the drugs tamoxifen and raloxifene. But you and your healthcare team will need to weigh the risks and side effects of those methods.

However, some people can find it difficult to cope with the kind of knowledge that they’re at high risk for breast cancer. At Vanderbilt, women can connect with someone to talk about the social-emotional issues that might accompany that news.

“We can identify risk factors and quantify them with genetics now, but it’s not a given that you will develop cancer,” Wiesner said. “It just means you’re at (elevated) risk.”

Women's Health Guide

Help for women with high risk

Vanderbilt has two clinics specifically designed to manage and support people who are at high risk for breast cancer:

Vanderbilt Health One Hundred Oaks
719 Thompson Lane, Suite 25000
Nashville, TN 37204

Vanderbilt Breast Center
324B Cool Springs Boulevard
Franklin, TN 37067

For appointments, call (615) 322-2064.

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