Am I at risk for breast cancer?
Am I at risk for breast cancer? I’ve been asked this question a million times. As an OB/GYN I see 100 patients a week in my office. Most worry about their breast cancer risk and they should. More than 180,000 women are going to get breast cancer this year in the United States. Are you at risk for breast cancer? That’s not the right question. The question should be am I at low, medium or high risk for breast cancer and when you go to your doctor this is a question that you should be asking.
Every woman is at risk for breast cancer. The job of the physician, my job, is to figure it out. I need to figure it out so I can give the patient advice, proper advice. This is a dynamic process. Sometimes, this means changing what you’ve been doing and sometimes it means you don’t have to.
Many factors are taken into account - gender, age, genetic risk factors, family history of breast cancer, personal history of breast cancer, race and ethnicity, dense breast tissue, certain pre-existing breast conditions, menstrual periods, lifestyle factors such as having children, contraceptive use, post menopausal hormone therapy, not breast-feeding, alcohol, obesity, lack of physical activity, high-fat diets and night work.
It goes without saying that gender is the most important risk factor as women are about 100 times more likely to get breast cancer than are men. Age is the second most important factor. The older someone is the more likely they are to get it. So much of the advice that I give is based on age. Let me give you a couple of examples. A woman shows up in my office for an annual checkup. I will call her Samantha. On second thought, I’ll call her Christina. She is 26 years old. Her main concern is birth control. As always, I take Christina’s history. I find nothing unusual. Her risk for breast cancer is low and I don’t change any of the recommendations that I give her. Christina comes to my office again. She is now 46 years old. Her main concern is her changing cycles. I take her history. Again, I find nothing unusual. But now due to her age I send her again for a yearly mammogram because her age risk factor says she is at increased risk compared to when she was 26 years old. It’s simple, more 46-year-olds get breast cancer than the 26 years old. Age plays one of the biggest roles.
The next on the list of risk factors is family history. About 5 to 10% of breast cancers are hereditary. This means that it is handed down from generation to generation. It may even be passed down through the male side of the family. Christina has a friend. Her name is Jane. When Christina was 26 years old Jane who was also 26 came for a visit. Unlike Christina, Jane had a family history of breast cancer. Jane’s mom had breast cancer at 39 years old and Jane’s grandmother had breast cancer at 60 years old. Why do I care about the family history if Jane is only 26? Why? Because Jane may not be low risk! I need to know. She needs to know.
This is the first installment of many. I will look at and discuss all of the different risk factors for breast cancer. What they mean and why they are important. How I approach them and how you should.
December 2, 2008 Comments (0) 
