New Tool to Assess Breast Cancer Risk

New tool helps assess the risk for breast cancer: Knowing your risk leads to more strategies for prevention and early detection
By Caitlin Lopez, MD

Mammography changed the course of women’s health care in 1976, when the screening test was first recommended for the early detection of breast cancer. Before then, cancer was typically diagnosed when a tumor could be felt by hand – many times too late for effective treatment. Millions of women are alive today because annual mammograms beginning at age 40 detect cancer at earlier and more treatable stages.

For women, just getting older places them at increased risk for breast cancer, but other factors contribute to lifetime risk as well. Women checking in for their annual mammograms at the Women’s Imaging Center at BMC are now invited to take a risk assessment survey that calculates the estimated lifetime risk for developing breast cancer. The survey asks about family history of breast cancer, the woman’s own medical history, at what age she started her period, whether or not she’s given birth, and more.  

It is important to note that this risk assessment does not predict whether or not a woman will develop breast cancer; its value is in estimating her level of risk, which provides potentially life-saving opportunities to take steps to reduce risk. Both the woman and her primary care physician will receive the results of the assessment survey and, depending on the level of risk, decide together what options are available to reduce risk.

Mammograms remain the most effective breast cancer screening tool for the general population, but screening for breast cancer with MRI - in addition to mammography - in women who are found to be at high risk for developing breast cancer is even more effective. In addition to MRI screening, women who are at high risk may also benefit from genetic testing and/or anti-hormone medications.

Although some additional tests are only for use in the high risk population, all women, including those with intermediate or average lifetime risk levels, can reduce their risk for developing breast cancer by maintaining a healthy weight, exercising, breastfeeding, limiting alcohol, and not smoking.

One of the difficult aspects of breast cancer screening is that women with calculated high risk don’t always develop breast cancer, and most breast cancers are diagnosed in average risk women. Knowing the lifetime risk for developing breast cancer is one way for women to make more informed decisions about their breast health and care.

Since the breast cancer risk survey was introduced at BMC in May 2018, 80 out of 4,159 women screened were found to be at high risk. In addition to letters sent to them and their physicians, nurse navigators at BMC followed up by phone to answer questions and provide more information if requested. We understand that “high risk for breast cancer” may be daunting words to hear, but our patients are eager to learn more, meet with their primary care physicians, and develop a strategy that emphasizes prevention and early detection.

October is Breast Cancer Awareness month. It’s a good time to schedule your mammogram and take the risk assessment survey. Be informed and get screened!

Caitlin Lopez, MD is Director of the Women’s Imaging Center at BMC