Increased breast cancer risk stems from age and genetics

BY HALEY LUCIAN ’17

Breast cancer is the most common form of cancer in women and is the second leading cause of death due to cancer among women, according to the Centers for Disease Control and Prevention. According to Breastcancer.org, it is estimated that 1 in 8 women will develop breast cancer in their lifetime, so it is not surprising that over time this topic lingers in the back of people’s minds.

Although the risk of developing breast cancer is known to increase with age, the National Cancer Institute, a part of the National Institutes of Health, tracks breast cancer among all ages and ethnicities. Statistically, at the age of 30 women begin to display a risk for breast cancer but that risk can depend on a number of factors, including ethnicity. Genetics can also play an important role in cancer development for women belonging to various risk groups. In fact, the risk for developing breast cancer is known to nearly double for an individual who has a first- degree relative that has been diagnosed. Despite this strong correlation, the majority of breast cancer cases actually do not have a familial connection. For the subset of genetically predisposed women who may develop an early-onset hereditary form of breast cancer, two genes are now known to be involved, BRCA1 and BRCA2. Genetic mutations in these two genes also increases the lifetime risk for other cancers, such as ovarian cancer, according to the CDC.

It should not be forgotten that transgender individuals are also at risk for developing breast cancer. Although there have been a few studies in recent years, collectively there has been insufficient data on breast cancer development among transgender individuals to offer an ind cation of prevalence. In 2013, the United States Department of Health and Human Services noted that LGBTQ individuals often receive less routine care, including critical breast cancer screening. As of Oct. 6 2016, the NIH will officially designate sexual and gender minorities as well as LGBTQ individuals “as a health disparity population for NIH research.” With this formal designation, hopefully valuable and long awaited breast cancer statistics can be collected on LGBTQ groups. But for now, even without available comprehensive statistics, screening for this particular at-risk group should be encouraged.

The American Cancer Society has set forth general screening guidelines for women at an average risk for breast cancer development. Beginning at the age of 40, women can begin yearly mammograms, if they wish, but by the age of 45, the ACS recommends all women be screened annually until the age of 55, when screening can become a biennial regimen.

Women who have a personal or family history of breast cancer, have a specific inherited mutation in one of the BRCA genes or have had radiation therapy to the chest are considered to be of above average risk for breast cancer. Thus additional precautions and screening methods are often recommended. These additional precautions most often include yearly MRIs and mammograms beginning at age 30 rather 40. A mammogram is one of the best ways to detect breast cancer early. An MRI, similar to a mammogram, is an additional method to detect breast cancer before it is symptomatic or has metastasized, that is to say, while it is still localized to the breast region. An MRI however, is usually only recommended for women of higher risk groups.

The ACS emphasizes that everyone should be aware of the benefits, but also of the limitations and potential harm, of breast cancer screening using radiation detection systems. No matter which group you may belong to, it is very important to do your own monthly breast exams and to make sure your doctor is performing a thorough breast exam during each annual physical.