With changing mammogram recommendations and uncertainty over risk factors, a local expert with the DMC Medical Group offers guidance.
Women in the U.S. have a one in eight chance of getting breast cancer during their lifetime – a staggering statistic that leaves many women wondering about their risk factors. Just how at risk are you? How much does family history play a role, and how often should you be screened? These questions are common, says Dr. Troy Sibson, M.D., an OB-GYN with the DMC Medical Group who sees patients at Hartland Obstetrics & Gynecology.
"I think it has gotten confusing for women because they hear so many different things in the media," he says. "They're getting different information from different people. Their friends tell them one thing; their doctor tells them something else." But having an accurate sense of your breast cancer risk is key to ensuring you get proper screening. "It's important because individually people may be at much higher risk depending on different factors," Dr. Sibson explains. October is Breast Cancer Awareness Month, so it's a good time to make an appointment with your OB-GYN to get your questions answered. In the meantime, here's a look at some of the main factors influencing a woman's risk of breast cancer.
First and foremost, women should understand that many cases of breast cancer are unpredictable. "The great majority of breast cancers are random," Dr. Sibson emphasizes. "They're not related to any genetics, they're not based on any family history, just random things." Only 5 to 10 percent of all breast cancers are related to a genetic mutation – "at least genetic mutations that we know about right now," he notes, and that could change in the future as researchers learn more over time. "It's a slow process to discover those things," he says.
Among the known risk factors, family history is important to helping women assess their risk of breast cancer. "Certainly family history is the biggest thing we can pick up on pretty easily," Dr. Sibson says. "If there's a first degree relative – mother, daughter – that has had breast cancer that definitely alters a person's risk." When a family history of breast cancer is present, it could mean earlier or more frequent mammograms. The American Congress of Obstetricians and Gynecologists recommends yearly mammograms starting at age 40.
Many women wonder whether they should undergo genetic testing to check for abnormal genes linked to a higher risk of breast cancer. "The BRCA gene testing can be done, which has become a lot more popularized with certain celebrities bringing that into people's consciousness, being aware of it," Dr. Sibson explains. But it's not exactly a patient's choice, in most cases. Insurance will only cover the testing when it's considered necessary due to a very strong family history of breast cancer. "There's an extensive questionnaire that we have them fill out," he says, noting that a grandmother, for example, who had breast cancer would not typically alone be enough to qualify. "That on its own isn't necessarily a strong enough risk factor to trigger BRCA testing."
Other Risk Factors
Some physicians use what's called the Gail Model to assess a patient's breast cancer risk. It uses seven factors to offer an overall risk percentage that applies to women with those risk factors. "It takes into consideration a person's age, how old they were when they had their first period, how old they were when they had their first child, family history of breast cancer, past breast biopsies, number of biopsies showing atypical hyperplasia and race or ethnic background," Dr. Sibson says. "It puts all those things together into a model and tells that person if somebody in that situation is at higher risk or not."
While the assessment is available online, it's best to go over your specific situation with your doctor. "It's really better to do that in conjunction with physician consultation so they can really go over the results with you and explain the results," he says. "A lot of people do things online and they kind of freak themselves out because they don't have anybody to help interpret information for them."
Talk With Your Doctor
The same advice goes for other questions you might have about what affects your breast cancer risk, such as prior radiation exposure, hormone replacement therapy or things like being overweight or a history of smoking. "If there are any questions you can always talk to the doctor," he says, adding that screening recommendations are there for a reason. "There's a lot of science behind that. It's the best we have right now."
Your doctor can also help you decide which screening tools are most appropriate. In addition to mammograms, women might also be sent for a breast ultrasound or breast MRI. Self-checks are also important. "We strongly encourage self breast exams and if they find something, certainly bring it up," Dr. Sibson says. "If you get used to what's there, then you know if something changes." And though it can be upsetting to notice a change, "don't ignore symptoms" over fear of the results, Dr. Sibson notes. "It is better to get seen on the early side to have much more treatment options."
For more information or to make an appointment with a DMC Medical Group physician, visit DMCMedicalGroup.com.