Although the majority of cases of breast cancer are not hereditary,
having a first degree relative, either on the mother's or father's
side, does increase the likelihood of developing breast cancer. A
good word of advice is to inform your family members of your diagnosis,
and suggest that your daughters or sisters be particularly thorough
in practicing early detection.
The current recommendations include yearly mammograms starting either
at age forty, or at an age that is ten years younger than yours at
the time of your diagnosis, whichever is earlier.
For younger women, whose breasts are more dense, and more difficult
to be examined by mammography, there are techniques available such
as ultrasound and MRI that will help spot smaller changes.
Mammography itself is constantly undergoing refinement. For example,
new digital systems make image management easier. There are also computerized
programs that enhance the physicians' ability to interpret images
rapidly and effectively. And for those women who avoid mammograms
for fear of the discomfort caused by the compression, new user-friendly
foam pads make much of the discomfort obsolete.
In addition, BSE is important for younger women, who are not yet
at the mammogram screening age of over 40. For these women, the only
tools readily available are clinical breast examinations and monthly
A newly released guideline recommends annual MRI in addition to
mammography for women who are at high risk of developing breast cancer—
which may include your first degree relatives.
One of the questions that women who have been diagnosed with breast
cancer ask is, "Should my close relatives be tested for breast
cancer genes?" This is not a simple question.
The tests that are available today look for abnormalities in the
BRCA genes. If abnormalities are found, then the person has a higher
risk of developing breast cancer.
The issue is, what will that person do with the information? At
present, the options include prophylactic mastectomy—removal
of both breasts as a pre-emptive measure, or hormone treatment (such
as with tamoxifen) that will induce menopause. Neither is an attractive
choice. In addition, if the test is negative, it does not mean that
the person will not develop breast cancer. If the test is positive,
there may be a risk that a health insurance company, or a potential
employer will somehow access the information, and use it in a prejudicial
The complicated decision of whether to undergo genetic testing should
be made with the help of a genetic counselor trained in risk assessment,
and the woman must be very clear about the expected benefits and risks.
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