Thursday, October 18, 2007

High Risk of Breast Cancer: 4 Factors

Breast cancer has struck within my family, and when it did I was worried not only for my relative (she's fine now, thank goodness), but also for myself.

After her diagnosis, when I asked my doctor if I should do anything beyond the norm to safeguard my health, the doctor's answer was, "Many more women who have no known relatives with breast cancer get the disease than do those who have a family history."

This was her way of reassuring me, and I've continued to live healthy by getting the usual screenings and not worrying constantly that I will be diagnosed. Every year I schedule my mammogram, and every so often I do a self exam, and I tell other women to do the same. These are the best cancer-fighting aids we have: awareness, action, and advocacy.

To get a quick snapshot of your own risk, based on your family history, Therese M. Bevers, M.D., medical director of the Cancer Prevention Center at The University of Texas M. D. Anderson Cancer Center, suggests you ask yourself the four following questions:

1. Do you have at least two blood relatives who were diagnosed with breast cancer before menopause?

2. Do you have a blood relative who was diagnosed with breast cancer before menopause and a blood relative who developed ovarian cancer at any age?

3. If you have a family history of breast cancer, were any of the diagnosed relatives male?

4. Is your family of Ashkenazi Jewish descent?

If you answered yes to 1, 2 or 3, or to 4 along with any other question, your family history of breast cancer implies a genetic predisposition, says Dr. Bevers.

Talk with your doctor about whether you should consider seeing a genetic counselor, who can give you a much more complete assessment of your risk. (You can also find a genetic counselor yourself at the National Society of Genetic Counselors.

If you learn that you are indeed at high risk, organizations like FORCE, Facing Our Risk of Cancer Empowered, can provide additional information and support.

One more very important point: The American Cancer Society now recommends that certain women who have a higher-than-average risk of breast cancer get a breast MRI along with their mammogram; and depending on the details of your family history, you may need to start screening as early as age 30 or sooner.

The test is able to spot changes that the X-ray might miss (though be warned that means a higher chance of an unnecessary biopsy). Who exactly should consider it? Women who have tested positive for a BRCA mutation; those who have a first-degree relative with a BRCA mutation; women who had radiation to the chest between the ages of 10 and 30 and those whose lifetime risk is 20 percent or higher.

If you said no to all of the questions listed above, or yes only to number 4, you are likely at average ris, which is probably lower than you think. A woman who has no family history has just a one in 13 chance of developing breast cancer in her lifetime, according to large study published in The Lancet.


Author Bio: Lucy Danziger is the editor-in-chief of SELF magazine. In 1991, SELF founded the Pink Ribbon to raise awareness and funding for breast cancer research. Each October, SELF produces a Breast Cancer Handbook feature. The 2005 handbook won a National Magazine Award for Personal Service. Danziger lives in Manhattan with her husband and two children.

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