High Breast Cancer Risk: When to Begin Screening

Some people will debate whether too much of a good thing is a good thing. We say yes, it’s especially a good thing when talking about screening for high risk breast cancer. It is recommended that women with a high breast cancer risk screen for breast cancer earlier and more often than women with a normal breast cancer risk. For those women with a high breast cancer risk, when should you begin screening?

What Makes a Women High Risk for Breast Cancer?

There are certain factors that causes both women and men to have a higher risk for developing breast cancer.

The following factors, plus others, may cause you to be high risk:

• Having the BRCA1 or BRCA2 inherited gene mutation and first degree relatives who are parents, siblings, and children with the mutation.
• Having a personal history of invasive breast cancer or ductal carcinoma in situ. (DCIS is a condition affecting the cells of milk ducts in the breast. The cell lining the ducts become malignant but stay in place. It is an early form of breast cancer.)
• Having a personal history of lobular carcinoma or atypical hyperplasia (atypical hyperplasia is a condition of precancerous cells. It isn’t cancer, but it increases risk.)
• Having radiation treatment to the chest between the ages 10 through 30.
• Having a greater than 20% lifetime risk of invasive cancer based mainly on family history.

If you have any of these risk factors, consult with your Ob Gyn to discuss your personal risk and to help you make a screening plan.

What Are the Current Screening Guidelines?

There are several organizations that make these screening determinations, and sometimes they disagree slightly.

The consensus is a woman with a high risk for breast cancer should begin screening every year and get a mammogram starting at age 30. 

In consultation with your Ob Gyn, you may also be advised to get an MRI or breast ultrasound every year. 

Women with average risk are now advised to begin screening at age 40 instead of 50. 

Breast Cancer Assessment

The American College of Radiology advises that all women get a breast cancer assessment by age 25. This is especially important for black women and those of Ashkenazi Jewish ancestry since they have a higher risk of breast cancer.

If you are 25 or older and have not had an assessment, it’s time to consult with your doctor about whether you should begin screening before age 40.