Breast Cancer & Genetics
Regular breast exams and mammograms are especially important for women who are genetically prone to breast cancer. About 5-10% of breast cancer cases are hereditary, most commonly resulting from a mutation in the BRCA1 or BRCA2 gene, which helps repair damaged DNA. When mutated, they cannot perform their job, leading to abnormal cell growth and potentially cancer.
The BRCA1 or BRCA2 gene mutation leads to a higher risk of developing breast cancer and developing it at a younger age. Women with the mutation must be particularly diligent about receiving regular mammograms and getting them early.
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What Are The Risks Of Having A Mammogram
Each time you have a mammogram, there is a risk that the test:
- May miss some breast cancers. And some cancers that are found may still be fatal, even with treatment.
- May show an abnormal result when it turns out there wasn’t any cancer . This means you may need more testsâsuch as another mammogram, a breast ultrasound, or a biopsyâto make sure you don’t have cancer. These tests can be harmful and cause a lot of worry.
- May find cancers that will never cause a problem . Some breast cancers never grow or spread and are harmless. You might have this type of cancer, but a mammogram can’t tell whether it’s harmless. So you may get cancer treatmentâincluding surgery, radiation, or chemotherapyâthat you don’t need.
- Will briefly expose you to very small amounts of radiation. While the risk from being exposed to radiation from a mammogram is low, it can add up over time.
| Ages 40â49 | About 19 out of 1,000 women |
|---|---|
| Ages 50â59 | About 30 out of 1,000 women |
| Ages 60â69 | About 44 out of 1,000 women |
*Based on the best available evidence
*Based on the best available evidence
Breast cancer diagnosis
Mammograms can find some breast cancers early, when the cancer may be more easily treated. Often a mammogram can find cancers that are too small for you or your doctor to feel.
Take a group of women who have a mammogram every year for 10 years.footnote 3
Survival
Risks
If You Are Called Back
Around 4 out of 100 women are called back for more tests. If this happens, you might feel very worried. But many of these women wont have cancer.
If you are called back because your mammogram showed an abnormal area, you might have a magnified mammogram. This can show up particular areas of the breasts more clearly. These mammograms show the borders of any lump or thickened area. They can also show up areas of calcium .
You might also have an ultrasound scan of the breast or a test to take a sample of cells from the abnormal area
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Undergoing Medical Screening For Breast Cancer
If You Have Any Symptoms Of Breast Cancer
Screening will not pick up all cancers. Cancer can occur at any time, including between your screening appointments.
Always see a GP right away if you have any symptoms of breast cancer.
Symptoms of breast cancer can include:
- a lump in either breast
- discharge from either of your nipples
- a lump or swelling in either of your armpits
- a change in the size or shape of one or both breasts
- dimpling on the skin of your breasts
- a rash on or around your nipple
- a change in the appearance of your nipple, such as becoming sunken into your breast
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What About Gene Testing For Breast Cancer
Certain types of breast cancer may be genetic. For example, if you have BRCA1 or BRCA1 genes, this may raise your risk of developing breast cancer, and ovarian cancer.
If youre concerned, for example, if breast cancer runs in your family, and youre worried you may also develop it, talk to your GP about genetic testing.
Not everyone is eligible and you would usually have to have good reasons to have this done. For example, if a relative has already been tested and shown to carry the BRCA1 or BRCA2. Testing is often inconclusive. You may also need to consider whether you really want to know, as a positive result may cause ongoing anxiety.
Start with a discussion with your GP about your family history and they will help you decide on next steps.
This article has been approved by womens health specialist Dr Elisabeth Rosen.
I Felt Something Like A Hard Round Piece Of Cheese
After a shower one night, I did a self-breast check. I felt something like a round, hard piece of cheese about the size of a quarter. I had just had a mammogram six months earlier. I felt healthy, biked all the time, and wouldnt have guessed that something wasnt right in my body. But I didnt wait to see what was going on. I went to the doctor immediately and was referred for an ultrasound and needle biopsy. I was diagnosed at age 46 with stage 3 breast cancer, and soon after had a mastectomy. I would never recommend to anyone to âwait and see.â While it was a very scary realization, youre only saving yourself if you take care of it aggressively.
Sandy Hanshaw, founder of Bike for Boobs, San Diego
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Is There A Particular Time Of The Month I Should Do Breast Self
Women should do a breast self-exam once a month, every month. Women who are still menstruating should perform a breast self-exam after their period. Women who have stopped menstruating and those who have very irregular periods can pick a day each month. Choose a day that is consistent and easy to remember, like the first day of the month, the last day of the month or your favorite number.
If You Have A Gene Mutation
If you have had tests that showed a change in a gene that increases the risk of breast cancer, the recommendations are slightly different.
UK guidelines recommend yearly MRI scans from:
- age 20 for women with a TP53 mutation
- age 30 for women with a BRCA1 or BRCA2 mutation
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What Is A Breast Self
BSE is when a woman physically and visually examines herself for any changes in her breasts and underarm areas. The U.S. Preventive Services Task Force has found evidence that suggests BSEs do not lower the risk for death from breast cancer. Therefore, if you choose to do BSE, it should not be used in place of, but in addition to, clinical breast examination and mammography.
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Velocity Urgent Care Is Here To Help
If you find something concerning while doing a breast self-exam or just want some peace of mind with a regular screening, its important to visit the doctor as soon as possible. Going to urgent care might not be your first instinct, but it can be a great choice for those who dont have a primary care physician. At Velocity Urgent Care, we are ready to help.
Our friendly, board-certified providers will complete a health history questionnaire and perform a physical exam when you come to visit. Then, they can refer you to a specialist for quick and easy follow-up care.
In light of the COVID-19 pandemic, we are taking serious safety precautions to ensure that our locations are as clean as possible. Weve put strict sterilization protocols into place and are carefully handling patients who may be contagious to ensure that each one of our clinics is safe for those who need urgent medical care or occupational health services.
Skip The Wait
Velocity Urgent Care offers convenient online registration that helps you limit your contact with others during a visit. You can sign up for an appointment online ahead of time and arrive when its time to be seen to skip the waiting room. We even offer text message updates so you can wait in the car until its time for your appointment.
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When To Get Help For A Breast Lump
If you find a breast lump or notice any other signs, always see your doctor as soon as possible, says Dr Rosen. Try not to panic, as the vast majority of lumps are benign and there may be other reasons for them. Also, lumps that hurt are usually not cancerous but hormonal. Your GP will examine you and refer you to a breast cancer unit or clinic for further tests.
What Should My Breasts Feel Like
Before you start thinking about signs and symptoms of breast cancer, its important to get to know your own breasts and how they usually look and feel. That way, you can spot any changes and report them to your GP quickly.
Every womans breasts are different in size, shape and consistency, and the NHS states that its normal for one breast to be larger than the other.
It also says you might find your breasts feel different at different times of the month due to your menstrual cycle. Similarly, after menopause, some womens breasts can feel softer and less firm.
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What Should I Be Looking For
Aside from finding a noticeable lump, breast cancer can have a number of different symptoms.
The NHS suggests seeing your GP if you notice any of the following changes:
- a change in the size, outline or shape of your breast
- a change in the look or feel of your skin, such as puckering or dimpling
- a new lump, thickening or bumpy area in one breast or armpit that is different from the same area on the other side
- nipple discharge thats not milky
- bleeding from your nipple
- a moist, red area on your nipple that doesnt heal easily
- any change in nipple position, such as your nipple being pulled in or pointing differently
- a rash on or around your nipple
- any discomfort or pain in one breast, particularly if its a new pain and doesnt go away
What Changes Am I Looking For
Always consult a doctor if you notice any of the following changes:
- A new lump, bumpy area, swelling or thickening in one breast or armpit thats different to the same area on the other side
- A change in the size, outline or shape of your breast
- A change in the look or feel of your skin, such as puckering or dimpling
- Nipple discharge
- Bleeding from your nipple
- A rash or redness on or around the nipple area or a sore that doesnt heal
- Any change in the position of the nipple eg: becomes inverted, or is pointing differently
- Any new discomfort or pain in the breast
Checking your breasts for lumps monthly will help you to become aware of how they look and feel, says Dr Rosen. Its perfectly normal, for example, to have one breast thats slightly bigger than the other. Most women have slightly asymmetrical breasts. What youre looking for is anything thats not normal for you. This means any changes and symptoms that werent there before.
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Should I Go For Breast Screening
Its important that you have access to enough information about the benefits and harms of breast screening to make the decision.
You can talk to your own doctor or nurse. Or you can contact the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.
How To Reduce Your Risk
While there are many factors that can contribute to the development of breast cancer, some lifestyle choices and habits can play a significant role. Smoking, drinking alcohol, and eating a poor diet are all bad habits that can increase your risk. Getting regular exercise and maintaining a healthy weight are good ways to reduce your risk. Certain birth control methods and hormone replacement therapies can also contribute to the development of this disease. If you have any of these risk factors, it’s important to talk to your doctor about them. And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.
Gethin Williams MD Ph.D. is the Medical Director of Imaging & Interventional Specialists.
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What Are The Warning Signs Of Breast Cancer
While different people have different symptoms of breast cancerand some dont have any at allwarning signs of breast cancer include new lumps in the breast and armpit, swelling of the breast, redness or pain in the nipple region, or change in the breast size.
Remember that some of these symptoms are associated with other conditions that arent cancer.
Why Breast Cancer Patients Should Pass On Covid
If you or a loved one has breast cancer you may have been told by your doctor to get one of the COVID shots. I disagree with this approach for many reasons.
Here are some things to research before getting the COVID shots:
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Screen For Breast Cancer
One component of a visit to the gynecologist is a thorough breast exam. Your doctor will palpate your breast tissue to feel for lumps or hard spots. If any are found, you may be referred for further diagnostic tests, like a mammogram or ultrasound. When breast cancer is diagnosed early, there is a better chance of successful treatment.
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Why Women Buy Into The Fear Around Breast Cancer
There are many factors that contribute to a womans fear regarding her breasts. First, there are all the new screenings and treatments that are continually added into protocol, such as 3D Tomosynthesis Mammography, what I call a better mousetrap. And, once screenings and treatment regimens become standard it is hard to remove them from practice, even when the evidence supports discontinuing them. In addition, even enlightened doctors simply dont want to risk NOT prescribing regular breast cancer screenings out of fear of litigation.
The reality is, if you buy into the cultural fears around breast cancer, you may be subjecting your breasts to harmful therapies and end up being diagnosed with, and treated for, something that would never harm you in the first place, such as DCIS Ductal Carcinoma in Situ, stage zero canceror cancer you may die with but not from. In fact, there is a movement afoot to change the name of this condition because the name itself scares so many people.
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There Are Many Reasons Why We May Not Check Our Breasts
Checking your breasts only takes a few minutes and everyone will have their own way of touching and looking for changes. Whether it’s in the bath, shower or before going to bed, checking for signs and symptoms is as easy as TLC.
Building new habits can take time. Checking as part of your self care routine, setting a reminder on your phone or making a note on your calendar can help.
You might feel scared to check, but remember: the sooner breast cancer is found, the more successful treatment is likely to be. Find out about what to look and feel for.
There is stigma, too, because we are talking about breasts. In some communities, you dont speak about these things. You dont speak about cancer. But not talking about it doesnt stop people from getting it.
– Bami