Knowing your risk level dictates how often you’re screened or even treated for breast cancer.
As of now, there is no guaranteed way to prevent breast cancer. Certain lifestyle habits can lower your breast cancer risk, but most of the time, there’s no clear reason why breast cancer develops. (Even genetic causes of breast cancer occur in fewer than 10 percent of cases, according to the American Cancer Society.)
That said, doctors do classify women into different risk groups (average, moderate, and high) to help determine how often they should be screened for breast cancer with mammograms or other imaging tests.
Factors for Average Breast Cancer Risk
You may fall into an average-risk level of breast cancer if you fit the following criteria:
Have no family history of breast cancer
Have no personal history of breast cancer
Are not a gene carrier
Have not previously had radiation to the chest
In many cases, women who have an average risk of breast cancer should begin screening between ages 40 and 49—although that’s ultimately a decision between you and your doctor. “Health care professionals will usually speak with women about the pros and cons of screening at that age,” says Brenda Panzera, MD, an oncologist at Lenox Hill and Mount Sinai Hospitals in New York City. (Here are more tests all women need in their forties.)
For women ages 50 to 74, doctors recommend screening for breast cancer with mammograms every one to two years. That’s because most breast cancer diagnoses occur in women over age 50, according to the Centers for Disease Control and Prevention. (Learn more tests women in their fifties need.)
“After the age of 75, the recommendations for screening depend on that individual’s life expectancy,” says Dr. Panzera.
Factors for Moderate Breast Cancer Risk
You may have a moderate risk of breast cancer if you fit the following criteria:
Have not previously had breast cancer
Have a family member with breast cancer (especially a first-degree family member) but do not carry breast cancer genes
“The recommendations for screening for a moderate-risk individual are the same as an average-risk individual,” says Dr. Panzera, “and that needs to be very carefully individualized for each person.”
Factors for a High Breast Cancer Risk
You are considered to be at high risk of breast cancer if you fit the following criteria:
Have previously had breast cancer
Have a first-degree relative with breast cancer who carries breast cancer genes
Are personally a gene carrier
Have had chest radiation between the ages of 10 and 30 (such as for Hodgkin’s disease)
“Breast cancer screening for high-risk individuals should [begin] with mammograms annually,” says Dr. Panzera. Additionally, doctors may also use ultrasounds and MRIs.
The age that those annual screenings should begin depends on the individual’s specific risk factors. “For individuals who have a family member who was a gene carrier, we will often start screening at least 10 years prior to the diagnosis of the individual who had previously been diagnosed,” explains Dr. Panzera.
Should You Start Screening for Breast Cancer?
If you’re unsure, ask your doctor about the right age and frequency to start breast cancer screening. Even though doctors have general guidelines for when screening should begin, these decisions are always individualized depending on your personal situation.
Want to learn more about reducing your breast cancer risk?
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So an average risk woman is an individual
who has no family history or
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personal history of breast cancer,
is not a breast cancer gene carrier, and
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has not previously had
radiation to the chest.
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In terms of when we recommend that women
begin breast cancer screening between
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the ages of 40 and 49, healthcare
professionals will usually speak with
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women about the pros and
cons of screening beginning at that age.
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For a woman who's age 50 to 74,
we would recommend breast cancer
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screening with mammograms,
typically every 1-2 year intervals.
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After the age of 75,
the recommendations for
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screening depend on that
individual's life expectancy.
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A moderate risk individual
is an individual who has
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not previously had breast cancer,
but has a family member,
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particularly a first degree family member,
who has had breast cancer but
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does not carry one of
the known breast cancer genes.
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The recommendations for screening for
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a moderate-risk individual are the same
as an average-risk individual.
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And that needs to be very
carefully individualized for
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A high risk individual is an individual
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who has previously had
breast cancer themselves.
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Or who has a first degree family member
with breast cancer who is a known
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gene carrier, but that person has
not been tested for the gene.
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Or if an individual is a known
breast cancer gene carrier, or
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if they've had chest radiation
between the ages of 10 to 30,
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chest radiation may have occurred
if that individual had had
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something like Hodgkin's
disease in the past.
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Breast cancer screening for
high-risk individuals should include,
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beginning with mammograms annually.
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Sometimes in addition to a mammogram
we'll use an ultrasound, and
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often times those
individuals will have MRIs.
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The age at which those individuals
start screening depends on what
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made them high risk.
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So for individuals who have a family
member, who was a gene carrier,
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we will often start screening
at least 10 years prior to
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the diagnosis of the individual
who had previously been diagnosed.
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Any women who has a question
about when to start screening for
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breast cancer should meet with their
physician or health care provider, and
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that decision should be individualized for
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Breast cancer risk factors. Ardmore, PA: Breastcancer.org. (Accessed on May 18, 2018 at http://www.breastcancer.org/risk/factors.)
Breast cancer risk factors you cannot change. Atlanta, GA: American Cancer Society. (Accesed on May 18, 2018 at https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html.)
What are the risk factors for breast cancer? Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on May 18, 2018 at https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm.)