Are You at High Risk for Breast Cancer?

By Nicolette McDonnell, APRN, Foundation Surgery 

Breast cancer is frequently in the news for good reasons. According to the American Cancer Society, it is the second most diagnosed cancer among women in the U.S. More concerningly, it is the second leading cause of cancer death among women overall and the leading cause of cancer death among Black and Hispanic women.   

So, what is your risk of developing breast cancer? Some women may develop breast cancer even if they are unaware of any other risk factors. Having a risk factor does not guarantee that you will get the disease, and the impact of different risk factors can vary. While most women have some risk factors, the majority do not develop breast cancer.  

Main Factors to Consider When Assessing Breast Cancer Risk  

As we discuss risk, it is important to recognize that each risk factor impacts the others. The biggest risk for getting breast cancer is being a woman over 50.  Beyond that, there are three common factors that can impact your chances of getting breast cancer. 

1. Family History  

   Only about 5-10% of breast cancer cases are hereditary. Hereditary breast cancers are caused by a genetic mutation that can be passed on through generations within a family and can significantly elevate a woman’s breast cancer risk. The age at which family members were diagnosed, as well as the number of relatives diagnosed, are crucial when considering a woman’s risk. Women with a first-degree relative (mother, sister, or daughter) or multiple members of the family with breast cancer on either side of the family (mother’s or father’s) are likely going to be at increased risk and should discuss it with a breast specialist.    

2. Prior High-Risk Lesion Biopsy or Cancer  

   Those who have previously had breast cancer are more likely to have it again. If you have had a biopsy that revealed high-risk lesions (such as atypical hyperplasia or lobular carcinoma in situ) this puts you at higher risk of breast cancer.   

3. Breast Density  

    Breast density is more commonly discussed in recent years. Although dense breast tissue is common (fifty percent of women have dense breast tissue), it is an independent risk factor for breast cancer. Having dense breast tissue can also decrease the accuracy of mammograms, making it harder to detect cancer early. If you have been told you have dense breast tissue on mammogram, you may want to discuss supplemental breast cancer screening with a breast specialist.   

4. Other Risk Factors 

Lifestyle and reproductive factors play a role in either raising or lowering the risk of breast cancer. If you have any of the above risk factors and are inactive, obese, or drink excessive alcohol, you increase your risk. In addition, starting your period before 12 or menopause after 55, having never been pregnant or breastfed, or having a first pregnancy after 30, increases your risk.   

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Actions to Take if You Are Considered High Risk for Breast Cancer 

If a professional risk assessment determines that your risk is above 20%, you and your provider may consider the following actions:  

1. Supplemental Screening  

 You may qualify for additional screening methods, such as MRI (Magnetic Resonance Imaging) or ultrasound, to catch any signs of cancer early.  

2. Risk Reduction Medication  

Certain medications can reduce your risk by up to 50%.  These medications are typically prescribed and managed by a medical oncologist.    

3. Genetic Testing  

Undergoing genetic testing can provide more information about your risk and help guide further preventive measures such as risk-reducing surgery and increased screening.   

The Power of a Mammogram  

The American College of Radiology and the American Society of Breast Surgeons recommend that women aged 40 should start annual breast cancer screening with mammograms. Regular mammography screening can reduce the risk of death and, along with advances in treatment, has significantly decreased breast cancer deaths.   

It is important to understand your level of risk so you can take preventative measures if necessary. If you think you may be at high risk, see a breast specialist, such as a doctor, nurse practitioner, or surgeon, for a thorough risk assessment to develop an individualized screening and risk reduction plan. 

Nicolette McDonnell, APRN, specializes in breast cancer risk assessment at Foundation Surgery.