Breast cancer screening depends on your risk score
BY BERNADETTE STARZEE Breast cancer screening
saves lives.
“Studies have
shown that early detection
of breast cancer decreases
mortality by 15 to
40 percent,” says Dr. Nina
D’Abreo, medical director of
the breast health program at
NYU Langone’s Perlmutter
Cancer Center-Long Island.
But while experts agree
on the need for breast cancer
screening, screening guidelines
have become increasingly
complex in recent years.
Organizations have released
different, sometimes contradictory
guidelines, and recommendations
have become
considerably more individualized,
based on a woman’s
risk factors.
On average, a woman has a
1 in 8, or about 12.5%, chance
of developing breast cancer
over her lifetime.
“Women who are at average
risk for breast cancer
should get a baseline mammogram
at age 40 and then continue
to get mammograms annually,”
says Dr. Alice Kim,
breast imaging director for
Catholic Health. “Women
whose breasts are heterogeneously
or extremely dense
should also be evaluated by
ultrasound.”
After age 75, “we still recommend
annual mammograms,
but women should
engage in shared decisionmaking
with their doctors,
with functional status and
life expectancy taken into account,”
Dr. D’Abreo said.
Women in their 20s should
begin receiving clinical
breast exams and discuss
their family history with
their gynecologist or primary
care physician to determine
their likelihood of carrying
the BRCA1 and/or BRCA2
mutations, which are associated
with a considerably increased
risk of breast cancer,
and whether genetic testing
is recommended, according
to Dr. Melissa Fana, chief of
breast surgery at South Shore
University Hospital in Bay
Shore and director of breast
services at Mather Hospital in
Port Jefferson.
Many factors are associated
with increased breast
cancer risk, and several
models are used to calculate
an individual woman’s lifetime
Accelerated Placement, Accepting Applications NOW!
BRONX TIMES REPORTER, O 24 CT. 15-21, 2021 BTR
risk. Guidelines call
for women whose lifetime
risk exceeds 20 percent to be
screened more closely.
The high-risk category
“certainly includes women
with the BRCA1 or BRCA2
mutation and certain other
genetic mutations,” Dr.
D’Abreo said. Risk is also elevated
for patients who have
had a prior history of abnormal
cell growth such as atypical
hyperplasia or lobular
carcinoma in situ (LCIS); a
personal history of breast
cancer; a fi rst-degree relative
– parent, sibling or child
– with premenopausal breast
cancer; two or more fi rst-degree
family members with
breast cancer, regardless of
their age at diagnosis; family
history of ovarian cancer or
male breast cancer; or a history
of radiation therapy to
the chest area.
Other factors go into calculating
a woman’s individual
risk, including reproductive
history and age at onset
of menstruation and menopause.
“For women with a lifetime
risk of 20 percent or
higher, MRI may be used as a
supplemental screening tool,”
Dr. Fana said. Annual MRIs
are typically given at sixmonth
intervals with the patient’s
annual mammogram
(and sonogram, if applicable).
Women with elevated risk
may be advised to begin annual
mammograms and other
screening tests before age 40.
If you do not know your
breast cancer risk, have a conversation
with your gynecologist
or primary care physician.
“When women come to us
for a mammogram, we calculate
their risk score and include
this information on the
mammography report,” Dr.
Kim said. “This assists gynecologists
and primary care
physicians in advocating for
their high-risk patients in getting
insurance companies to
authorize MRIs.”
Breast cancer risk models
such as Tyrer-Cuzick have
risk assessment calculators
on the web that allow women
to input factors such as age,
height and weight, age of menstruation
onset, pregnancy
history, and family history,
among others, to calculate
their risk.
But it’s best to discuss
breast cancer risk with a
healthcare provider.
“Some models may overestimate
some factors, and
women may be alarmed by
the fi ndings,” Dr. Abreo said.
“Context matters. It’s important
to talk to your doctor
about your risk of getting
breast cancer and what
screening is appropriate for
you.”
Photo courtesy Getty Images
FIRST 10 ELIGIBLE
APPLICANTS FOR
SIXTH GRADE
WILL BE ACCEPTED
NOW THROUGH OCTOBER 30TH, 2021 !
For IMMEDIATE ENROLLMENT,
email: info@equalitycs.org
BRONXNEWSPAPER_FF.indd 1 9/21/21 7:20 PM
link
link