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Some women have a higher chance of being diagnosed with breast cancer. The factors that increase your chances of having breast cancer include having a personal history of breast cancer.  If you have had cancer before, you have an increased risk of developing a new cancer in another part of the same breast or in the other breast. In addition, if you have relatives (e.g., your mother, sister, daughter) who have been diagnosed with breast cancer, you have an increased risk of developing breast cancer. A history of breast cancer in your family may be linked to having an abnormal gene that is passed on over time. For example, mutations in genes such as BRAC1BRAC2 and PTEN are linked to breast cancer, and these mutations can be passed on from parent to child.

Breast cancer screening

For women with a personal history of breast cancer, or a family history of breast cancer and/or a family history of abnormal breast-cancer related genes, speak with your health care provider to discuss breast cancer screening guidelines. The doctor will discuss which screening option may be right for you, whether you need to be screened earlier or more frequently than other women. Some screening options include:

  1. Genetic Testing: There are genetic tests available to determine if you have mutations in genes that are associated with increased risk of developing breast cancer. A genetic counselor may order testing for mutations in the following genes individually or as part of a larger panel such as BRCA1, BRCA2ATM, CDH1, CHEK2, PALB2, PTEN, TP53.
  2. Frequent Screening: A screening plan for a woman at high risk of developing breast cancer may include:
  • breast ultrasound
  • monthly breast self-exam 
  • yearly breast exam by your doctor
  • yearly mammogram starting at age 30 or younger
  • yearly MRI scan every year starting at age 30 or younger

Women with an abnormal breast cancer gene have a much higher risk of developing breast cancer in between yearly screenings. For example, women with an abnormal BRCA1 or BRCA2 gene are recommended to have a mammogram and an MRI scan each year, about 6 months apart (for example, a mammogram in January and an MRI in July).

Risk lowering options

For women with a higher risk of breast cancer, there are several options for reducing your chances of developing breast cancer. These decisions require much thought, research and discussion with your healthcare team. Take the time to carefully consider these options and make the best decision for your health:

  1. Risk-Lowering Drugs: Drugs such as Tamoxifen, Evista (Raloxifene), Aromasin (Exenestane) and Arimidex (Anastrozole) can reduce the chances of developing first-time hormone receptor positive breast cancer. However, since these drugs have side effects, you should speak with your healthcare provider about the potential harms and benefits of these drugs.
  2. Preventative Surgery: Removing healthy breasts (prophylactic mastectomy) can be a way to reduce breast cancer risk in women with mutations in the BRCA1 or BRCA2 genes. Prophylactic mastectomy may reduce a woman’s risk of developing breast cancer by as much as 97%. However, some breast tissue remains after this surgery, thus there is a small chance that breast cancer can still occur.
  3. Clinical Trials: You may consider joining a clinical trial that is focused on reducing breast cancer risk in women who have a higher risk of developing breast cancer. This will give you access to new, cutting edge research and medications.
    Coping with new body image

    For some women, physical changes associated with breast cancer have a strong emotional impact.  If you choose to undergo a prophylactic mastectomy, your new body image may affect how you feel sexually, and as a woman.  Joining an in-person support group, getting peer support or speaking with a health care provider or counselor can help you.

    It’s important to know your breast cancer risk.  Take this brief quiz to find out more. This questionnaire will help you determine whether you should be further evaluated for Hereditary Breast and Ovarian Cancer syndrome, Lynch syndrome, or other hereditary cancers.  Take the quiz here!