Breast Cancer Risk Assessment

Breast cancer is a result of proliferated growth of breast tissues in females. It is one of the most commonly diagnosed cancers in females. It is imperative to study the risk of breast cancer in women if they have any family history of the same. 

Breast cancer risk assessment will help you determine the type of treatment you need if you are at high risk and want to be treated sooner. Health care providers will offer you genetic counseling, breast cancer screening, and detailed information regarding genetic testing. 

About Breast Cancer Risk Assessment

Breast cancer risk assessment includes evaluating your personal history of breast biopsies, breast density, and family history to check whether you are more likely to develop breast cancer or not. 

Breast cancer risk assessment will help you make an informed decision regarding screening. There are many breast cancer risk-assessment models available to help you and your doctor categorize your risk for breast cancer. 

Generating accurate risk assessment and making evidence-based screening recommendations is highly beneficial for women at a high risk of breast cancer.

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Risk Factors Associated With Breast Cancer Risk Assessment

There are many risk factors associated with breast cancer risk assessment, such as:

1. Screening may put a patient through unnecessary hassle as a result of falsely positive test results.
2. Otherwise harmless lesions or non-malignant tumors or lesions may be overdiagnosed.
3. Average risk screening recommendations may be wrongly applied to women at higher risk of cancer and vice-versa.

Preparing for Breast Cancer Risk Assessment

Before breast cancer risk assessment, the doctor may evaluate your personal family history.

Women who appear to be at risk of breast cancer must be referred for genetic counseling based on screening their family histories of only BRCA related cancers (breast, ovarian, peritoneal, or tubal cancer) or family history related to BRCA mutations. 

Doctors will ask you about all cancer diagnoses in first and second-degree relatives and their age of diagnosis. After taking samples of the blood or saliva or a swab of the inside of a cheek, genetic testing may be done, after which the samples are sent to the laboratory. 

If you have a high-risk genetic mutation, then a high-risk screening protocol will be followed. If your family history screen is positive and genetic testing is positive, your doctor may continue to the next step.

Breast cancer risk assessment also includes a review of your personal history. It includes the following factors:

1. Demographics – age and ethnicity
2. Hormonal risk factors – age of menarche or menopause, age of first live birth, hormonal use, obesity
3. Radiographic breast density
4. Breast biopsies history or atypia

If you have a history of atypia, there is no requirement for further risk assessment since you are already at high risk. Hence you have to undergo a high-risk screening protocol.

What Next To Expect From Breast Cancer Risk Assessment?

There are three risk prediction models that may be used to assess your risk of breast cancer:

1. National Cancer Institute Gail Model – It is a statistical model or tool based on the patient’s personal history, used to estimate the risk of developing invasive breast cancer. This work majorly on risk-reducing medications. The disadvantage of this model is that it doesn’t include second-degree relatives and breast density.
2. Breast Cancer Surveillance Consortium Model – This model is based on the Gail model but includes breast density and breast biopsy results. The BCSC model includes only first-degree relatives with breast cancer but not the age of diagnosis or family history of ovarian cancer.
3. Tyrer-Cuzick Model – Tyrer-Cuzick model includes a more comprehensive family history, includes second-degree relatives, ovarian cancers, age of diagnosis of family members, family members without cancer, genetic testing information, hormonal factors, weight, height, and atypia. This is the only model that includes extensive family history. 

Interpreting Risk Assessment: Results

The results obtained from these models will help you to know when the screening must start, how often screening is required, and recommendations for risk-reducing medications.

1. High-Risk Screening – Women with more than 20% lifetime risk of developing cancer must undergo yearly breast MRI scans and yearly mammograms from 10 years before the onset of breast cancer in the youngest affected family member. 

You must be informed about the risks and benefits of using risk-reducing medications like tamoxifen, raloxifene. To reduce breast cancer chances in females with high risk, they are provided with estrogen-blocking medicines, such as selective estrogen receptor modulators and aromatase inhibitors.

2. Intermediate risk screening – All the women at moderate risk of breast cancer must undergo yearly mammography after 40. Such women need not undergo MRIs routinely. 

When to See a Doctor?

Many symptoms appear in your body to indicate the presence of breast cancer. Such symptoms are:

1. You might experience a lump in your breast or underarms, which doesn’t go away. 
2. If the breast cancer has spread to the lymph nodes, you may experience swelling in the armpits or near the collarbone.
3. You might experience pain or tenderness in the breast.
4. You can observe changes in the size, texture, color, or temperature of your breast. 
5. Your nipples might have turned inward or shown some swelling, pain, itching, burn, or might develop sores. 
6. You might observe some unusual discharge from your nipples.
7. You could also observe flat or indented areas in your breasts.

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Conclusion

By following the risk assessment tools, your doctors can depict your risk of suffering from breast cancer. Based on the risk assessment tools mentioned above, it becomes easier to evaluate the risk of breast cancer in females. This helps in saving many lives by detecting cancer as early as possible. 

Breast cancer risk assessment is highly recommended to women with a family history of cancer. With the increasing rates of cancer mortality, it’s essential to protect yourself and get cured easily. 

Frequently Asked Questions (FAQs)

Q1. How can I determine the risk of breast cancer?

If your mother, sister, daughter, any first-degree relatives, or family members from your mother or father’s side have suffered from breast or ovarian cancer, then you are also at the risk of breast cancer.

Q2. What is the Tyrer-Cuzick score?

The Tyrer-Cuzick score is a tool used to calculate the likelihood of BRCA1 or BRCA2 mutations in the body of females responsible for breast cancer. This tool helps to detect the chances of breast cancer in the course of a lifetime.

Q3. Why are women with fatty or dense breasts at high risk of suffering from breast cancer?

Women with dense breasts are at a higher risk of suffering from breast cancer. But in such women, breast cancer is likely to be less dense than that in females with non-dense (fatty) breasts.

Q4. What is the risk of breast cancer in females?

Nearly 1 out of 8 women in the world develop chances of breast cancer in an 80-year lifespan. Younger women have considerably fewer chances of suffering from breast cancer than older ones.

Q5. What are some of the symptoms of breast cancer?

Symptoms of breast cancer include:

1. Lumps in the breast or underarms
2. Swelling or thickening of parts of the breast
3. Irritation in the breast skin
4. Redness and pain in the nipple area
5. Nipple discharge or bleeding