Breast Cancer Risk

One in eight women may develop breast cancer during her lifetime. The statistics are troubling — especially if you are higher risk or if the results of a recent exam or mammogram are causing concern.

The good news is that recent studies have changed the “one size fits all” approach to identifying risk. The American Cancer Society has released new screening guidelines that define who falls into the “high risk” category, making it easier for those who want to take a proactive approach to their health.

At Northwestern Lake Forest Hospital’s Posy Krehbiel Breast Care Center, we’ll help you understand your risk and provide the most personalized, advanced breast care in the region. We’ve even developed more inclusive, detailed guidelines, based on our cancer specialists’ experience, for women at high, above-average and average risk.

More specific risk groups means more targeted screening procedures. For example, Breast Magnetic Resonance Imaging (MRI) screening is recommended for high-risk patients because of its more precise detection capabilities. And the MRI evaluation is just one of the options we have at the Posy Krehbiel Breast Care Center.

Learn more about your specific risk group and what you can do to protect your health.

• Definition of High Risk for Breast Cancer
• Understanding High Risk
• Understanding Above-Average Risk
• Understanding Average or Low Risk

For more information, contact the nurse navigators at the Posy Krehbiel Breast Care Center of Northwestern Lake Forest Hospital at (847) 535-6401 or email nursenavigator@lfh.org.

Definition of High Risk for Breast Cancer

AMERICAN CANCER SOCIETY

Recent studies have shown the benefits of defining different levels of breast cancer risk in women. In April 2007, The American Cancer Society released the following new guidelines for women at high risk of developing breast cancer:

• Women who have a first-degree relative with the BRCA1 or BRCA2 gene mutation have an 85 percent greater risk of developing breast cancer. These genes are involved in cell growth, division and DNA repair which, when mutated, increase an individual’s risk.
  
  
• Women with multiple first-degree relatives with breast and/or ovarian cancer, or with one or more first-degree relatives with pre-menopausal breast cancer, have a 20-25 percent or greater lifetime risk of developing breast cancer. You can calculate these factors by several accepted risk-assessment tools available at the Breast Care Center.
  
  
• Individuals who received chest radiation between 10 and 30 years of age for cancers such as Hodgkin’s disease are at higher risk.
  
  
• Women with Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or who have a first-degree relative with one of these rare cancer predisposition syndromes, are at higher risk for breast cancer.

 

POSY KREHBIEL BREAST CARE CENTER SCREENING GUIDELINES

Northwestern Lake Forest Hospital's guidelines for high risk are based on those published by The American Cancer Society. However, the Society’s guidelines do not cover all groups of women with above-average risk factors.

In keeping with our dedication to individualized breast care, we’ve established a more detailed, inclusive set of guidelines for three specific risk groups along with recommended screening procedures:

• High Risk
• Above-Average Risk
• Average or Low Risk

Understanding High Risk

HIGH RISK CHECKLIST

By our criteria, the following factors define a woman at high risk for breast cancer:

• Mother or sister diagnosed with breast cancer before age 50 or before menopause
  
  
• Two or more close relatives with breast and/or ovarian cancer, at least one being a mother, sister or daughter
  
  
• Three close relatives diagnosed with breast cancer at any age*
  
  
• A father, brother or son diagnosed with breast cancer
  
  
• A mother, sister or daughter diagnosed with bilateral breast cancer, with the first cancer diagnosed before age 50
  
  
• Personal history of bilateral breast cancer
  
  
• Two or more of the following:
  • Atypical ductal hyperplasia or lobular carcinoma in situ on a previous biopsy
  • Personal history of breast cancer
  • One or more close relatives with breast and/or ovarian cancer
    
    
• BRCA1 or BRCA2 mutation or a first-degree relative with this mutation
  
  
• Chest radiation received between the ages of 10 and 30
  
  
• Other rare gene mutations, such as the TPS3 gene, PTEN gene, ATM gene, CHEK2 gene

 

ADDITIONAL SCREENING STRATEGIES FOR WOMEN AT HIGH RISK

Aside from exams and mammograms, women at high risk may benefit from an annual breast MRI. The MRI is a diagnostic tool more sensitive than mammography at detecting breast cancer, and may be used in conjunction with a mammographic view or ultrasound to aid in proper diagnosis.

The following screening procedures are recommended for women at high risk: 

• Annual mammography beginning at age 30, or 10 years earlier than the youngest relative diagnosed with breast cancer. Northwestern Lake Forest Hospital does not recommend mammography prior to age 20.
  
  
• Annual breast MRI beginning at age 30, or 10 years earlier than the youngest relative diagnosed with breast cancer. Northwestern Lake Forest Hospital does not recommend breast MRI prior to age 20.
  
  
• Annual clinical breast exam beginning at age 30
  
  
• Monthly self breast exam beginning at age 20 is also an option

*“ Close relative” is defined as a parent, brother or sister, child, grandparent, aunt or uncle, nephew or niece. The affected relatives must come from the same side of the family, such as the mother’s or father’s side.

Understanding Above-Average Risk

ABOVE-AVERAGE RISK CHECKLIST

The following factors define a woman as above-average risk for breast cancer:

• Atypical ductal hyperplasia or lobular carcinoma in situ on a previous biopsy
• Previous history of breast cancer
• One close relative with breast cancer diagnosed after age 50

Please keep in mind that if you have one of the above factors in combination with dense breast tissue or multiple previous biopsies, you may be at high risk for developing breast cancer. And you should be aware that other health factors, such as early menarche, late menopause, having no children (or having them late in life), alcohol consumption and hormone therapy might also increase your risk.

 

SCREENING STRATEGIES FOR WOMEN AT ABOVE-AVERAGE RISK

The following screening procedures are recommended for women at above-average risk:

• Annual mammography beginning at age 40 — you may also seek a baseline mammogram at age 35
• Clinical breast exam every three years in your 20s and 30s and annually after age 40
• Monthly self breast exam beginning at age 20 is also an option

Understanding Average or Low Risk

AVERAGE OR LOW RISK CHECKLIST

The following factors define a woman at average or low risk for breast cancer:

• No personal history of breast cancer, atypical ductal hyperplasia or lobular carcinoma in situ
• No significant family history of breast cancer

 

SCREENING STRATEGIES FOR WOMEN AT AVERAGE OR LOW RISK

The following screening procedures are recommended for women at average or low risk:

• Annual mammography beginning at age 40
• Clinical breast exam every three years in your 20s and 30s and annually after age 40
• Monthly self breast examinations beginning at age 20 is also an option