What Is High Risk For Breast Cancer

What Are The Early Warning Signs Of Breast Cancer That Should Prompt Medical Evaluation

The majority of breast cancers have no symptoms and are detected during screening with mammogram or other breast imaging studies.

However, some warning signs include:

• A new lump in the breast or in the armpit
• Dimpling or thickening of the breast skin
• New redness on the skin
• New pulling in of the nipple
• Nipple discharge
• Change in shape or contour of the breast
• New and persistent breast pain.

If you have any symptoms that might worry you, please contact your doctor.

What Does High Risk For Breast Cancer Really Mean

One out of every eight women will develop breast cancer in their lifetime this is considered average risk for U.S. women. High risk for breast cancer is defined as a greater than or equal to 20% lifetime risk, or in other words, a one in five chance of developing breast cancer over a lifetime. We all know someone a coworker, family member such as a mother, sister, daughter or friend that has been diagnosed with this disease.

Thats why for decades, October and the color pink have gone hand in hand to promote Breast Cancer Awareness. Regular screenings and a healthy lifestyle have been shown to reduce a womans risk for developing breast cancer. In addition to these important actions, you need to be aware of our own individual lifetime risk for breast cancer. Summa Health answers your top questions about what it means to be high risk and how you can take charge of your breast health this month and every month to reduce your risk of breast cancer or detect it at its earliest stages when it is most treatable and curable.

How do I know my risk for Breast Cancer?

The risk for breast cancer is not the same for all women, as it depends on your individual health history and family history. A high risk designation can be determined by one factor or a combination of factors.

What factors increase my risk for Breast Cancer?

With The Cdc Warning That People With Weakened Immune Systems Are More Likely To Suffer Severe Illness From Coronavirus Many Are Wondering: Who Falls In This Category An Oncology Nurse Practitioner And Md Have The Answers

This past week, the co-operative grocery stores in my area announced their first hour of operation every day will be reserved for the elderly, pregnant women and at-risk populations as defined by the CDC.

This decision has many in my community wondering who counts as high risk. According to the Centers for Disease Control , those with chronic conditions such as heart disease, diabetes or lung disease are at higher risk for severe illness if they contract coronavirus. But the CDC also notes that people with a weakened immune system are among those most at risk.

So what exactly does it mean to be immunosuppressed and who falls in that category?

Who Has a Weakened Immune System

People who are immunosuppressed have immune systems that are highly susceptible to infectious diseases, including COVID-19, the respiratory illness caused by coronavirus. Not only are these people more likely to contract illnesses, sometimes repeatedly, but they are also more likely to have unusually severe symptoms.

A person can become immunocompromised in four major ways: through a congenital disorder through acquired conditions such as diabetes and HIV through autoimmune diseases and through certain medications and treatments.

I recently spoke with Lisa Kennedy Sheldon, Ph.D., chief clinical officer at the Oncology Nursing Society, and an oncology nurse practitioner, about the link between cancer treatments and immunosuppression.

Rushed to the ER: Life with Immunocompromise

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Insurance Coverage Of Breast Mri Screening

Insurance coverage for breast MRI screening varies. You may want to check with your insurance company before getting a breast MRI for screening to see if its covered.

Under Study: Screening With Breast Mri For Women Whove Had Breast Cancer

Mammography plus breast MRI is under study for screening for new breast cancers in women whove had breast cancer. Its not clear whether or not screening with breast MRI offers a benefit to women whove had breast cancer. Its also not clear whether any potential benefits outweigh the risks. So, its not routinely recommended.

Learn about breast cancer screening for women whove had breast cancer.

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How Common Is Breast Cancer In Canada

Breast cancer is one of the most common forms of cancer in women. Each year, more than 22,000 women develop breast cancer in Canada and more than 5,000 women die of the disease. Based on current rates, one in nine women in Canada is expected to develop breast cancer during her lifetime.

The risk of getting breast cancer goes up as women get older. The risk of developing breast cancer in the next 10 years is as follows:

• 13 out of 1,000 women in their 40s
• 23 out of 1,000 women in their 50s
• 29 out of 1,000 women in their 60s
• 31 out of 1,000 women in their 70s

Since 1999, the rate of new cases of breast cancer has stabilized, and death rates have steadily declined.

Reproductive History Estrogen Is The Main Hormone Associated With Breast Cancer Estrogen Affects The Growth Of Breast Cells Experts Believe That It Plays An Important Role In The Growth Of Breast Cancer Cells As Well The Type Of Exposure And How Long Cells Are Exposed To Estrogen Affects The Chances That Breast Cancer Will Develop

Early menarche

The start of menstruation is called menarche. Early menarche is when menstruation starts at an early age . Starting your period early means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk of breast cancer.

Late menopause

Menopause occurs as the ovaries stop making hormones and the level of hormones in the body drops. This causes a woman to stop menstruating. If you enter menopause at a later age , it means that your cells are exposed to estrogen and other hormones for a greater amount of time. This increases the risk for breast cancer. Likewise, menopause at a younger age decreases the length of time breast tissue is exposed to estrogen and other hormones. Early menopause is linked with a lower risk of breast cancer.

Late pregnancy or no pregnancies

Pregnancy interrupts the exposure of breast cells to circulating estrogen. It also lowers the total number of menstrual cycles a woman has in her lifetime.

Women who have their first full-term pregnancy after the age of 30 have a slightly higher risk of breast cancer than women who have at least one full-term pregnancy at an earlier age. Becoming pregnant at an early age reduces breast cancer risk.

The more children a woman has, the greater the protection against breast cancer. Not becoming pregnant at all increases the risk for breast cancer.

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Brca1 And Brca2 Gene Mutations

When it comes to breast cancer risk, the most important inherited gene changes are in the BRCA1 and BRCA2 genes. Women with one of these gene changes are said to have Hereditary Breast and Ovarian Cancer syndrome.

• Women with a BRCA gene change have a greatly increased risk of breast cancer, as well as an increased risk of ovarian cancer, pancreatic cancer, and possibly some other cancers.
• Men with a BRCA gene change are at increased risk of breast cancer , prostate cancer, pancreatic cancer, and possibly some other cancers.

If you have a family history of breast cancer, you have a higher risk of getting breast cancer yourself. Most women with a family history of breast cancer do not have an inherited gene change that greatly affects their risk. Still, an inherited gene change is more likely in women with a strong family history of breast cancer, especially if the family history also includes certain other cancers, such as ovarian, pancreatic, or prostate cancer. The risk of having an inherited syndrome is also affected by:

• Which family members are affected
• The number of family members affected
• The age when your relatives were diagnosed

Making Sense Of Your Risk Factors

Figuring out your breast cancer risk isnt simple, so its important to work with your doctor to do it. Doctors often use The Breast Cancer Risk Assessment Tool to estimate risk, but this model may not be the most accurate tool for black women. There are other risk assessment tools out there, so talk to your doctor about which might work best for you.

You can prepare for a conversation with your doctor with this Know Your Risk tool. There are also online tools to estimate risk specifically related to family history and inherited gene mutations.

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Screening For Women At Above

For women who have an above-average breast cancer risk but aren’t exactly at high risk somewhere around 15 to 20 percent lifetime risk, for example the ACS guidelines note there’s not enough evidence to make a screening recommendation.

It’s women who fall into this “middle ground” of risk that are challenging in terms of recommendations, Garber says.

“We have to walk a fine line, because there’s worry that we’re overdiagnosing women who have cancers that would not be dangerous, and that are very slowly growing, Garber says. And you don’t want to overtreat people.” But she acknowledges that some cancers will be missed following these guidelines.

Practical Limitations Of Risk Models

Although simple tabular or scoring systems are easy to use and can generate mutation carrier probabilities in as little as 12 minutes, computer-based programs can take up to 15 minutes to input all the relevant data. Nonetheless, computer-based programs can be carried out in clinics to generate pedigrees and store family information.

All risk assessment models have limitations: Adoption, small family size , and lack of information about family history reduce the usefulness of all models to some degree. It is known that because of the reluctance of people to discuss their medical conditions, particularly those involving cancer, generations of family medical history are lost to present-day patients who are receiving care in the era of genetic testing . Of additional concern is the mistaken assumption that a paternal family history of breast or ovarian cancer is not relevant to risk for cancer . Furthermore, it is known from the noncancer and cancer literature that the reporting of parental medical history by offspring can be inaccurate. There is therefore a need to improve methods for collecting and acknowledging family history even while risk models continue to have their accuracy improved.

In view of the current weaknesses in the collection of data needed for these models and the inherent limitations of the model algorithms themselves, it has been recommended that the use of these model-based predictions should only occur in conjunction with clinical judgment .

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Screening For Women At High Risk

If a woman has a lifetime risk of 20 to 25 percent or higher or a known BRCA1 or BRCA2 mutation, the ACS recommends a more intensive screening regimen, which includes annual MRI scans and mammograms.

But the problem with MRIs is that they’re too sensitive and not specific enough, meaning an MRI can show numerous lesions that are not breast cancer, which can lead to unnecessary biopsies, Garber says. MRIs also require use of a contrast agent an injected medicine that makes lesions more visible which may have side effects.

Women at high risk may also have the option of taking medication to lower their risk. Tamoxifen and Evista , for example, are drugs that lower breast cancer risk by at least 50 percent, Garber says.

The most extreme options include preventive surgeries to remove your breasts and possibly ovaries, according to national guidelines.

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Are You At Increased Risk For Developing Breast Cancer

The cause of breast cancer is not yet fully understood. Risk factors are conditions that are known to increase a persons chance of developing cancer. Just having these conditions does not mean you will necessarily develop cancer. Additionally, cancer can form in people without any identifiable risk factors. Risk factors can be controllable and uncontrollable . Knowing your risk factors can help you to be aware of your risk and guide lifestyle and health care choices.

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Having Radiation To Your Chest

Women who were treated with radiation therapy to the chest for another cancer when they were younger have a significantly higher risk for breast cancer. This risk depends on their age when they got radiation. The risk is highest for women who had radiation as a teen or young adult, when the breasts were still developing. Radiation treatment in older women does not seem to increase breast cancer risk.

Are There Other Genetic Mutations That Increase My Breast Cancer Risk

Yes. The more we learn, the more we discover that there are many other mutations that increase the risk for breast cancer. These include genes like PALB2, CHEK2, P53, and others. The risk from each of these mutations is variable.

A physician or genetic counselor can use information about your family history to determine whether testing for these other mutations would be indicated.

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Risk Factors You Can Change

• Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
• Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
• Taking hormones. Some forms of hormone replacement therapy taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives also have been found to raise breast cancer risk.
• Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
• Drinking alcohol. Studies show that a womans risk for breast cancer increases with the more alcohol she drinks.

Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk.

What Are The Risk Factors For Breast Cancer

Being a woman and getting older are the main risk factors for breast cancer.

Studies have shown that your risk for breast cancer is due to a combination of factors. The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.

Some women will get breast cancer even without any other risk factors that they know of. Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer. If you have breast cancer risk factors, talk with your doctor about ways you can lower your risk and about screening for breast cancer.

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Understanding Breast Cancer Risk

Lisa Schlager does not regret getting preventive surgeries to remove her ovaries at age 40 and her breasts at 41, but there were costs.

“If I could do it again, I don’t think I’d change what I’ve done. But there’s definitely a sense of melancholy that this is what it came to that this is what I had to do,” Schlager says. She hopes for better options for her 16-year-old daughter.

For most women, the lifetime risk of breast cancer is about 12 percent if you live to be 90. But for Schlager who discovered in 1999, at age 32, that she carries the BRCA1 genetic mutation the risk was four to five times higher prior to her bilateral mastectomy.

Women at above-average risk for breast cancer may need to consider earlier or additional screening than women at average risk or even medication or surgery to lower their risk.

The tricky part is that “high risk” is not black and white, nor are screening guidelines clear cut for women at elevated cancer risk.