Breast cancer: Measuring your risk
The National Cancer Institute estimates that 13.4 percent of women born today (1 in 7) will be diagnosed with breast cancer at some time in their lives. Unfortunately, despite the diligent ongoing research on the disease, doctors and scientists still don't know exactly what causes breast cancer and why some women get it while others don't. You can, however, learn more about the factors in your life that can increase your risk of developing breast cancer. Here are some helpful tools.
Tools to help you measure your risk of breast cancerThough the causes of breast cancer are still being sought, researchers have come up with a list of risk factors associated with breast cancer as well as tools to help women assess their lifestyle and risks.
Understanding Breast Cancer Risk ToolThe National Cancer Institute has an Understanding Breast Cancer Risk Tool (http://understandingrisk.cancer.gov/a_Breast/02.cfm) that gives you a list of known risk factors, questions to help you determine if the risk factors apply to you and gives you the ability to print your list so you can refer to it (also an important list to take to your doctor to further discuss).
Breast Cancer Risk Reduction Action ToolAs an adjunct tool, the National Cancer Institute also has a Breast Cancer Risk Reduction Action Tool (http://understandingrisk.cancer.gov/a_Breast/03.cfm) that lists known risk cancers and ways you can reduce those risks if they apply to you. You can also print out these results to discuss with your doctor.
Questions to ask your doctorTalking to your doctor about breast cancer can feel too personal, you might be embarrassed, or you may be one of those women who think it can't happen to you. Regardless of your reservations, make an appointment with your doctor and talk about your breast cancer risks as well as an action plan to reduce them.
Here are the questions to ask, as recommended by the National Cancer Institute:
- Do you think I should be worried about breast cancer?
- What puts me at risk for breast cancer? (Use the tools mentioned above to get a list before seeing your doctor.)
- How often should I get a mammogram? (Read this quick guide to breast exams for more information.)
- I heard there are different types of mammograms. Can you explain them to me?
- Are there other things I can do to reduce my risk of breast cancer? (See the risk reduction tool above.)
- I noticed a change in my breast - describe it. Should I be worried about breast cancer because of this change? What should we do to watch it over time?
- What are the benefits of menopausal hormone therapy (hormone replacement therapy) for me? What are the risks? Do the benefits outweigh the risks?
- No one in my family has had breast cancer. Does that mean I won't get it?
- Here is my family history. What are the chances that a gene alteration is involved in the breast cancer that has been in my family? Do I need genetic counseling?
Breast Cancer Risk Assessment ToolAnother helpful tool – that is more geared towards your health care provider – is the Breast Cancer Risk Assessment Tool, a computer program developed by scientists at the National Cancer Institute and the National Surgical Adjuvant Breast and Bowel Project (NSABP) to assist health care providers in discussing a woman's risk of developing invasive breast cancer.
The tool allows a medical professional to project a woman's individual estimate of breast cancer risk over a five-year period of time as well as over her lifetime, then compares the woman's risk calculation with the average risk for a woman of the same age. The Breast Cancer Risk Assessment Tool should not be used to calculate breast cancer risk for women who already have a diagnosis of breast cancer, lobular carcinoma in situ (LCIS), or ductal carcinoma in situ (DCIS). (Click to find out more on the different types of cancer.)
There has been concern about the comprehensiveness of the test because some risk factors, such as age at menopause, birth control pills, body mass index, high-fat diet, alcohol consumption, radiation exposure, and environmental pollutants, are not included. However, such risk factors are not included because evidence is not conclusive, because researchers aren't sure if these factors add useful information to the factors already in the model, or because data on other risk factors was not available in the research data used to develop the model. More research is being done and improvements to the tool are likely to come.
The Breast Cancer Risk Assessment Tool can be found at: http://www.cancer.gov/bcrisktool.
What is your risk of breast cancer?Though researchers have identified risk factors which influence a woman's chance of getting breast cancer, keep in mind that many women who develop breast cancer have no known risk factors other than growing older, and many women with many known risk factors do not ever develop breast cancer. Your best defense is to do self-checks and get regular clinical screenings and mammograms, and be aware of – and work to reduce – the risk factors you have in your life. You have the tools, now it is up to you to use them.
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