Breast cancer risk assessments are a key tool in identifying individuals who may be at higher risk for developing the disease, according to Jennifer Plichta, MD, a breast surgical oncologist at the Duke Breast Risk Assessment Clinic.
“A breast cancer risk assessment can determine your risk for developing breast cancer and help you identify when, how, and how often you should be screened. It takes many factors into consideration, including your family history and your personal risk factors. For example, your age, race, health, and components of your health history can all influence your risk of developing breast cancer at some point in your life,” said Dr. Plichta.
Dr. Plichta recommends that people have their initial risk assessed between ages 25 and 30. Those with a family history of breast cancer—especially if relatives were diagnosed young or if multiple family members have had the disease—should seek assessment as soon as they become aware of this history. She notes that “your breast cancer risk also changes with your age and with changes in your risk factors over time.”
During an assessment, doctors review both family and personal health histories. “A breast cancer risk assessment will delve into your family and health history. Your family’s history of cancer — not just of the breast, but all cancers — is important knowledge for you to share with your doctor. To prepare for your assessment, find out about the types of cancers in your family, as well as the ages at which your family members were diagnosed,” Dr. Plichta explained.
Patients are also asked about their own medical backgrounds since several factors influence breast cancer risks such as age at menstruation onset or menopause, hormone replacement therapy use, prior radiation therapy, or abnormal biopsy results.
“We use this data to calculate your risk of breast cancer. We also use it to make recommendations on next steps. These may include when and how often to have screening mammograms, whether you need additional testing, and whether we need to actively work to lower that risk,” she added.
While primary care physicians can conduct these assessments during annual checkups, patients may be referred to specialists depending on their histories: “Your primary care doctor can perform a breast cancer risk assessment during your annual physical. However, depending on your personal and family history, your primary care doctor may refer you to a breast specialist. He or she can then provide your primary care doctor with a plan that’s best for your individual needs.”
Dr. Plichta emphasized the importance of these assessments: “A breast cancer risk assessment is important because it can identify women who would benefit from additional breast cancer screening. Studies show about one out of every five women who undergo routine screening mammograms falls into a higher breast cancer risk category and may benefit from additional imaging, such as breast MRIs, to detect breast cancer at the earliest possible stage.”
She also noted that assessments help pinpoint those who might carry genetic mutations linked to increased risks: “Breast cancer risk assessment can also identify women who should be tested for a genetic mutation that increases their risk of developing breast cancer and other types of cancer. Studies indicate that up to 80% of women who have one of these genetic mutations don’t know it. Knowing you have a genetic mutation may impact your decision to opt for preventive surgery — such as prophylactic mastectomy or removal of your ovaries.”
