When you’re with family or friends – virtually or in-person – chances are that someone in your circle has either had breast cancer or is close to someone who has.
Early detection of this common type of cancer is vital because breast cancer is easier to treat and there are more options available, meaning that patients have better outcomes.
Preventive screenings and breast cancer risk assessment tools play an important role in early diagnosis. Jennifer Steiman, MD, a breast cancer surgeon at Magee-Womens Surgical Associates, explains how to use two free, online calculators to determine your risk of developing breast cancer within five years and over the course of your lifetime.
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What Are Risk Assessment Models?
You or your provider can evaluate your risk of developing breast cancer by using the Gail Model Risk Assessment or the Tyrer-Cuzik Breast Cancer Risk Evaluation Tool, commonly referred to as the IBIS model. Dr. Steiman notes the Gail tool is most effective in estimating a patient’s five-year risk, but has some limitations. It doesn’t factor in personal history, age of cancer onset (if applicable), ovarian cancer history, or known risk factors.
“Because of these limitations, a more sophisticated tool – the IBIS model – was created,” says Dr. Steiman. The platform, used by providers, considers multiple degrees of family members, including male relatives, ovarian cancer history, and the risk of invasive/non-invasive cancer.
“While there are many benefits to using this risk calculator, it can overestimate your risk if you’ve ever had a breast biopsy that showed atypia and lobular carcinoma in situ,” Dr. Steiman notes. “These high-risk lesions are associated with an increase in the future risk of developing breast cancer.”
Imaging Recommendations Differ Between Risk Groups
A patient’s percentage of lifetime risk determines the most effective breast cancer screening method for them. There are three types of risk:
- Average-risk patients have a 12% to 15% lifetime risk
- Intermediate-risk patients have a 15% to 20% lifetime risk
- High-Risk patients have a 20% to 25% and over lifetime risk
According to the American Cancer Society, average-risk patients do not have a personal history of breast cancer, prior chest radiation at a young age, and a confirmed or suspected genetic mutation that would increase their risk of breast cancer. Age is also a factor in determining if, when, and how often you should get a mammogram, which is an x-ray of your breast tissue.
Dr. Steiman says the intermediate risk group is the more challenging group. “We know that mammograms are helpful in this patient population, but the addition of a breast MRI could also be effective,” she says. She advises that patients should discuss their family history and risk percentage with their provider to determine next steps.
An annual breast magnetic resonance imaging (MRI) is recommended for the high-risk population, ages 25-75, who have a strong family history of breast cancer and/or a genetic mutation. Mammograms should also be included for screening in this group, starting at age 30 and annually thereafter.
Reducing Your Breast Cancer Risk
If you’re at high risk for developing breast cancer, there are three options for reducing your risk:
- A healthy lifestyle with regular exercise, nutritious diet, and moderate alcohol consumption
- Mastectomy surgery, which includes three forms: total, skin sparing, or nipple-sparing
- Medication, such as anti-estrogen therapy and aromatase inhibitors
Dr. Steiman – who practices in Oakland at UPMC Magee-Womens Hospital and at the new UPMC Outpatient Center on Clairton Boulevard in West Mifflin – recommends you discuss your risk of developing breast cancer with your doctor, determine your risk group, and practice breast self-awareness.
Read more about the Magee-Womens Breast Cancer Risk Assessment Program, or to schedule an appointment, call 412-623-3425.
You can also search and schedule with all UPMC physicians, searching by condition, specialty, provider name, or practice name, using Find a Doctor.
If you are over 40 years old, a prescription is not required for a screening mammography.
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