High-Risk Breast Cancer

Understanding how to manage genetic and lifestyle factors that may increase your risk for breast cancer.

Breast cancer doesn’t discriminate. Gender, age, health -- it can strike anyone. However, certain people are at higher risk of developing breast cancer than others.

Understanding your personal and family history can help you take steps to lower your risk or get more screenings for the disease.

Am I at high risk for breast cancer?

Aging, being female, or having had breast cancer in the past puts you at higher risk for breast cancer. Other factors include:

• Family history: Some families carry genetic mutations that can be passed from parent to child. BRCA1 and BRCA2 are the most common genetic mutations associated with breast cancer. And even these account for less than 10 percent of breast cancer cases. Just because you carry these genes doesn’t mean you will develop breast cancer. BRCA mutations are more common in Ashkenazi Jewish families and women diagnosed with particular breast cancers such as triple-negative breast cancer.
• Radiation exposure: If you receive therapeutic doses of radiation to the chest wall, your risk for breast cancer will increase, especially if you have these during adolescence or early adulthood. Mantle irradiation for Hodgkin’s lymphoma is an example.
• Postmenopausal obesity: Estrogen can cause some breast tumors to develop and grow. After menopause, the main source of estrogen comes from fat tissue. This increases breast cancer risk in obese women.
• Dense breasts: Breast tissue that appears especially thick on a mammogram.
• Menstrual history: Starting your period before age 12 and going into menopause after age 55.
• Reproductive history: Never giving birth or having a child after age 35.
• Alcohol consumption: Regularly drinking alcohol in excess.

What can I do if I’m at high risk for breast cancer?

Talk with your physician. You may be able to manage your risk through increased screening, lifestyle modifications or other interventions, such as:

• Early and increased screening: If your family has a history of early-onset breast cancer, you should begin annual mammograms five to 10 years before the youngest age of breast cancer diagnosed in your family.
• Supplemental imaging: In addition to a mammogram, we may recommend a breast MRI or breast ultrasound.
• Genetic testing: If you’re diagnosed with early-onset breast cancer or your family history points to a potential genetic mutation, we may recommend genetic testing to help you make proactive decisions about your health.
• Chemoprevention: Hormonal therapy medicines can lower your breast cancer risk by 50 to 70 percent, depending on the medication. However, there is a significant risk of side effects. Weigh your breast cancer risk against these side effects before you decide on chemoprevention.
• Preventive (or prophylactic) mastectomy: Removing both breasts can reduce the risk of breast cancer by up to 95 percent, but the surgery is serious, complex and irreversible.
• Preventive (or prophylactic) oophorectomy: Removing the ovaries pre-menopause can reduce breast cancer risk by 50 percent. This option has become more common among women with BRCA mutations.