If you’re concerned about your personal risk of breast cancer, you’re not alone. Breast cancer is a common concern, and many factors can contribute to an individual’s risk. Understanding your risk, seeking medical advice, and taking proactive steps can help ease your anxiety and empower you to make informed decisions about your health. In this article, we’ll guide you through what you can do if you’re worried about breast cancer, and how you can take steps to assess and reduce your risk.
1. Understand Your Risk Factors
Why it matters: Many factors contribute to breast cancer risk, including both uncontrollable elements (such as age and genetics) and lifestyle choices. It’s important to understand which factors may apply to you so you can take appropriate steps.
Key Risk Factors:
- Age: The risk of breast cancer increases with age, particularly after age 50.
- Family History: Having a close relative (mother, sister, daughter) with breast cancer, especially at a young age, can increase your risk.
- Genetics: Inherited mutations, such as BRCA1 and BRCA2, significantly increase the risk of developing breast cancer.
- Personal Medical History: If you’ve had breast cancer or certain non-cancerous breast diseases, your risk is higher.
- Reproductive History: Starting your period before age 12, having your first child after age 30, or starting menopause after age 55 can raise your risk.
- Hormone Replacement Therapy (HRT): Long-term use of hormone therapy after menopause can increase your breast cancer risk.
- Lifestyle Factors: Obesity, lack of physical activity, smoking, and alcohol consumption are all factors that can elevate your risk.
2. Get a Risk Assessment
Why it matters: A risk assessment helps you and your surgeon understand whether you’re at high, moderate, or low risk of developing breast cancer. Based on your unique profile, you can decide on the appropriate screening measures and lifestyle changes.
How to Get a Risk Assessment:
- Family History Evaluation: Your surgeon may ask about your family history of breast cancer and other cancers.
- Genetic Counselling: If your family history suggests a genetic predisposition, you may be referred for genetic testing (for BRCA mutations, for example).
- Risk Calculation Tools: Tools such as the Gail Model can estimate your five-year and lifetime risk of developing breast cancer based on factors like age, family history, reproductive history, and lifestyle choices.
What to Expect During Genetic Testing:
- A sample of your blood or saliva is analysed to determine if you have mutations in genes (like BRCA1 and BRCA2) that increase your breast cancer risk.
- Counselling: A genetic counselor will help you understand what the results mean for your risk and your options for reducing it.
3. Schedule a Clinical Breast Exam and Mammogram
Why it matters: Regular screenings are key to detecting breast cancer early when it is most treatable. Even if you’re worried about your risk, routine check-ups can provide peace of mind and may catch any potential issues early.
UK Screening Guidelines:
- Mammograms:
- Women aged 50 should be invited to start 3 yearly mammograms.
- If you are at higher risk this screening will start at an earlier age.
- Clinical Breast Exams: Have a healthcare professional perform a breast exam at least once a year, especially if you’re at high risk.
Additional Screening Options for High-Risk Individuals:
- Breast MRI: If you are at high risk for breast cancer, your surgeon may recommend a breast MRI in addition to mammograms.
- Ultrasound: Some women with dense breast tissue may benefit from ultrasound screening.
4. Make Lifestyle Changes to Lower Your Risk
Why it matters: While some risk factors (like age or genetics) cannot be controlled, others—like lifestyle habits—can be adjusted to lower your overall risk of breast cancer.
Key Lifestyle Changes:
- Maintain a Healthy Weight: Excess body fat increases oestrogen levels, which can increase breast cancer risk.
- Stay Physically Active: Aim for at least 150 minutes of moderate exercise or 75 minutes of vigorous activity each week.
- Limit Alcohol Intake: Even small amounts of alcohol increase breast cancer risk, so limit intake to one drink per day or less.
- Avoid Smoking: Smoking has been linked to a higher risk of breast cancer, particularly in premenopausal women.
- Eat a Balanced Diet: Focus on fruits, vegetables, whole grains, and lean proteins. Limit processed and high-fat foods.
- Consider Breastfeeding (if applicable): If you’re able, breastfeeding can lower your risk of breast cancer, especially if you nurse for longer than one year.
5. Discuss Preventive Options with Your Doctor
Why it matters: If you are at high risk of developing breast cancer due to genetics or other factors, your doctor may recommend additional preventive measures. Some of these are more aggressive but can significantly reduce your risk.
Preventive Options:
- Medications (Chemoprevention): Drugs like tamoxifen or raloxifene can reduce the risk of breast cancer in women at high risk.
- Preventive Surgery (Prophylactic Mastectomy): In extreme cases, high-risk women may opt for preventive removal of the breasts or ovaries (oophorectomy) to dramatically reduce their risk.
- Enhanced Screening: Some high-risk women may be monitored more frequently with imaging tests like mammograms and MRIs.
6. Monitor Yourself for Signs and Symptoms
Why it matters: While regular screening is important, you are your best advocate for early detection. Be aware of any changes in your breasts and promptly report anything unusual to your doctor.
What to Look for:
- Lumps or thickening in the breast or underarm area.
- Changes in breast size, shape, or appearance.
- Dimpling, puckering, or redness of the skin.
- Inverted nipple or nipple discharge.
- Persistent pain in a specific area of the breast.
FAQs
1. I have a family history of breast cancer. Does that mean I’ll definitely get it?
Not necessarily. While a family history can increase your risk, it doesn’t guarantee you’ll develop breast cancer. Many people with a family history never develop the disease, especially if they adopt healthy lifestyle habits and get regular screening.
2. How often should I get a mammogram?
In the UK Women aged 50 will be invited for 3 yearly mammograms. If you are at high risk this invite will be earlier dependent on the level of risk.
3. What does it mean if I have dense breast tissue?
Dense breast tissue can make it harder to detect cancer on a mammogram and may slightly increase breast cancer risk. Women with dense breasts may benefit from additional screening, like ultrasound or MRI.
4. Can men get breast cancer?
Yes, although it’s less common, men can develop breast cancer. Men with a family history of the disease or mutations in the BRCA genes may be at higher risk.
5. Should I get genetic testing if I’m worried about my breast cancer risk?
If you have a strong family history of breast or ovarian cancer, genetic testing may be recommended. Speak with your surgeon to discuss whether testing for BRCA or other mutations is right for you.
Conclusion
If you’re worried about your personal risk of breast cancer, the most important thing you can do is take action. Start by understanding your risk factors, getting a proper assessment, scheduling regular screenings, and making lifestyle changes to reduce your risk. By being proactive about your health and staying informed, you can better manage your risk and achieve peace of mind. Always discuss your concerns and options with your healthcare provider for the best personalized advice.
Mr Senthurun (Seni) Mylvaganam
Consultant Oncoplastic Breast Surgeon
