Know Your Breast Cancer Risk

KNOW YOUR BREASTCANCER RISK

A Valley Hospital oncologist urges women to learn more about their bodies—and families—to guard against this disease.

Except for skin cancers, breast cancer is the most commonly diagnosed cancer among American women. In fact, it’s estimated that 30 percent of all new cancer diagnoses in women last year were breast-cancer cases—approximately 287,000 new cases of invasive breast cancer in women were reported last year in the U.S., according to breastcancer.org. The numbers would be even more staggering if it weren’t for the efforts of awareness campaigns and advocates like Eleonora Teplinsky, M.D., head of breast medical oncology at The Valley Hospital in Ridgewood. Dr. Teplinsky was one of the featured speakers and a panelist at BERGEN’s Women’s Health & Wellness Event, which took place this past November at Edgewood Country Club in River Vale. There she stressed to an audience of about 175 women the importance of screening and knowing breast-cancer risk factors. “Risk assessment should start at age 25 and be updated periodically thereafter,” she advises. A risk assessment typically includes an examination of family history to determine if someone either has a genetic predisposition or should get genetic testing. And specialists don’t simply look at a patient’s maternal history. “It’s from Mom’s side and Dad’s side,” says Dr. Teplinsky. “We have to keep in mind the family history from the father’s side. A lot of times we speak of BRCA from Mom, but men too can have the BRCA gene.” About 1 in 833 men will develop breast cancer, she notes, and BRCA2 mutations are associated with a lifetime breast-cancer risk in men of about 6.8 percent, according to breastcancer.org.

For patients who are unable to trace their family’s health lineage, such as those who are adopted and don’t know their biological parents, Dr. Teplinsky still recommends a risk assessment.

“If you don’t know family history, we’re really limited,” she says. “But we’ll err on the side of caution and start screening at age 40. We’ll do genetic testing even though you don’t have a family history because it’s really important for testing for genetic mutation.”

A breast-cancer risk assessment also weighs other factors such as breast density, any prior radiation to the chest and any prior breast biopsies. “If you’re considered to be of average risk—which means you don’t have any of those factors—then we recommend starting screening at age 40 with a mammogram once a year,” says the doctor. “If you have dense breasts, which is information you get on your mammogram, then you would also want to add a supplemental breast screening ultrasound.”

About half of the U.S. female population has dense breasts, a risk factor that “is not meant to be a bad thing,” Dr. Teplinsky says. “Density can change over time: Breasts can be dense when we’re younger and turn fatty when we get older. You just need to be aware of it so you can advocate and get that ultrasound. It’s one extra tool that can help risk assessment, and you can be proactive in taking the next steps.”

Patients whose assessments suggest they’re at high risk—through factors such as family history and genetic mutation—may “be getting mammograms and MRIs, and may start screening earlier depending on what their risk is. If you have a first-degree relative who’s been diagnosed with breast cancer, you want to start screening at either 10 years before the age when they were diagnosed or at age 40, whichever comes first,” she recommends.

Below is a recommended timeline for risk assessment and screenings for women, according to the American Cancer Society: • Age 25: Begin doing a risk assessment to determine when to start regular mammograms. • 40 to 44: You have the option to start screening with a mammogram every year. • 45 to 54: You should get mammograms annually. • 55 and older: You can switch to a mammogram every other year or choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.

All women should understand what to expect when getting a mammogram for breast cancer screening— what the test can and cannot do.