You might be tempted to dismiss your risk of developing breast cancer due to a lack of family history. Or perhaps, to worry incessantly about it because of some family history. However, as women, we are all at risk of getting breast cancer. Yes, men are also at risk. But simply being a woman is the number one risk factor. We talked with Dr. Michele Boyce Ley, board-certified breast cancer surgeon and medical director of the TMC Breast Health Program about assessing your risk.
What factors play into breast cancer risk:
- being female
- getting older
- family history
- not having children or having children after age 35
- receiving hormone replacement therapy
- lack of exercise
- more than four alcoholic drinks a week
Dr. Michele Boyce Ley explains the key here is if multiple people from multiple generations in your family have been diagnosed, then you’re considered high-risk. “If your aunt had breast cancer when she was 65, for example, it’s probably not as important as if your mom had breast cancer at age 45,” she said. However, most women with breast cancer do not have a family history. Don’t ignore other factors because your family has no history of breast cancer.
Online high-risk assessments
Additionally, there are some easy-to-use scoring methods online to help you figure out if you’re high-risk or not. We have an online health risk assessment tool you can use and connect you with our nurse navigators if it appears that you’re at high risk. Still not sure? It’s best to get established with a breast specialist to assess your risk and what to do about it. A breast specialist can also help you figure out your breast density, which oftentimes can be another risk factor.
What about genetic testing for breast cancer risk?
Genetic testing is also an option, but proceed with caution. It’s not for everybody, and there are lots of caveats. Dr. Boyce Ley said it really needs to be done by a breast health specialist. Testing used to be limited to just testing for the BRCA 1 and 2 genes. Now there are numerous companies which offer genetic testing for up to 25 different markers. Certainly good information to have, but oftentimes it turns into a case of “We have this info. Now what do we do with it?”
While these mutations have been identified, it takes a highly trained team of clinicians to know how to interpret the results. Genetic testing can make a big difference in the treatment planning but it’s not a one-size-fits-all approach. “The testing can be helpful, but it’s not helpful in the same way for every person,” said Dr. Boyce Ley.
“I always tell my patients who want to pursue genetic testing this: Let’s think this through. If you get the testing done, and you get these results, what are you going to do about it? Your motivation might be to protect yourself or simply to help your children figure out their risk.”
Dr. Boyce Ley warns, however, that testing can have implications for an entire family. “Sometimes there is guilt associated with it if people realize they have passed this gene onto their kids. This isn’t like getting a blood test and finding out you have high cholesterol. It’s a bit more complex than that,” she said. That’s why it’s important to sit down and talk with an expert. Insurance coverage of genetic testing has gotten measurably better with the exception of Medicare, which is more restrictive in covering the cost.
Bottom line: Have a plan before you get genetic testing done.
Doctors continue to develop a better understanding about what characteristics constitute a high-risk patient, and there are an assortment of new drug therapies in the pipeline that work to reduce a patient’s risk. “Just because you’re identified as high-risk doesn’t necessarily mean you need an invasive procedure,” Dr. Boyce Ley said.
Something super simple you can do to reduce your risk of breast cancer that isn’t talked about much? Exercise and manage your weight. “It’s been shown over and over again that maintaining a healthy weight and exercising more than four times a week reduces the risk of breast cancer. Those are things where you don’t need to see a doctor. They’re not easy, but they’re free!” she said.
The TMC High-Risk Breast Clinic is at 2625 N. Craycroft Road, #201. Call (520) 324-BRST (2778) to make an appointment