High risk of breast cancer: Screening guidelines 

No single woman is exempt from the risk of developing breast cancer. Nevertheless, some women have a definitive increased risk. Your screening instructions differ when you have a high risk of breast cancer. In this article, Dr Rohan Khandelwal, a leading breast cancer expert at the CK Birla Hospital, sheds some light on the breast cancer screening guidelines for women with above-average risk. 

What determines a high risk of breast cancer?

Some women are more vulnerable to developing cancerous cells in their breasts. There is a wide variety of risk factors that determine this predisposition. Some of the common risk factors of breast cancer include:

• Personal history of breast conditions: If you have suffered from breast-associated ailments and undergone a biopsy, your chances of developing this cancer increase significantly. 
• Family history: Breast cancer can be inherited. If one of your blood relatives have lived with breast cancer, you are at a higher risk for breast cancer as well. 
• Genetic mutations: There are specific genetic variations that make you more vulnerable towards developing cancer. If you have inherited or experienced such a change in your genes, your risk of breast cancer largely increases. 
• Obesity: Obesity attracts multiple illnesses such as heart diseases, high blood pressure and even breast cancer. 
• Getting periods early: If you have started your periods at an early age, that is before age 12, your risk for breast cancer increases. 
• Getting menopause late: Your breast cancer risk increases if you start your menopause after the age of 50.
• Not becoming pregnant: Women who experience pregnancy and breastfeed their babies benefit from a reduced risk of breast cancer. This possibility, on the other hand, increases if you choose not to get pregnant.
• Excessive alcohol: Studies have shown that an excessive intake of alcohol leads to breast cancer in women. 

Breast cancer early detection is the ideal strategy for effective treatment. If you have an association with any of the above-given risk factors, your breast cancer screening guidelines are altered to offer an optimal diagnosis. 

What are breast cancer screening tests?

Breast cancer early detection is possible with routine screening tests. Breast cancer screening tests are a group of tests that help in the identification and detection of cancer cells in the breast at an early stage. Screening tests are used by healthcare providers to look for signs and symptoms of cancer cells.  

Patients can avoid developing cancer to an advanced stage and receiving relevant treatment beforehand with the help of screening tests. These tests are only a way for detection and should not be misunderstood as breast cancer prevention options. 

Some of the common types of breast cancer screening tests include:

• Mammogram: A mammogram is an imagining test for breasts. It is similar to an X-ray and helps your doctor to visualise the insides of the breast. 
• Breast MRI: Breast MRI (Magnetic Resonance Imaging) is an important medical tool for diagnosing breast cancer. This technique uses high-frequency radio waves to produce cross-sectional images of the breasts. This test is useful in the detection of smaller lumps of breast cancer cells. Women who have high breast density also benefit from breast MRI. 
• Clinical breast exam: One of the most common types of breast cancer screening is a clinical evaluation of the breasts. It a manual checkup of the breasts. Your doctor or nurse will screen your breasts for lumps or abnormal changes.
• Self-exam: A breast self-exam is similar to a clinical evaluation, except it is done by a woman herself. In a breast self-exam, you are required to stand in front of a mirror and analyse your breasts for possible changes in its size, shape or appearance. A self-exam also requires you to feel your breasts for any lumps.

Your doctor may indicate other screening tests such as CT scans, ultrasound, PET scans, biopsy and more if and when the need for them is suspected. 

Watch the video as Dr Rohan Khandelwal, Breast cancer specialist – the CK Birla Hospital explains how to perform breast self-examination and how often it should be done.

What are the breast cancer screening guidelines?

The breast cancer screening guidelines differ for women depending on their risk factors. All women have an average risk of breast cancer, irrespective of their predisposition. However, only some have a higher risk. 

Since breast cancer early detection is more crucial for women with an increased risk, the instructions for screenings are different for them. 

Guidelines for women with an average risk for breast cancer

Women with an average risk for breast cancer should implement the following protocol for screening:

• Women should start going for annual breast cancer checkups between the age of 25-40 years. 
• You should have yearly mammograms starting from age 40. 
• You should schedule annual checkups to watch out for breast cancer signs and symptoms. 
• You should discuss the findings of the mammogram with your breast cancer specialist. 
• You should perform breast self-exam routinely starting from the age of 25 to check any changes in your breast size, shape or appearance. 

Guidelines for women with high risk for breast cancer 

Frequent and additional tests are indicated for women with high risk for breast cancer. 

• Women who have high risk of breast cancer should start getting annual mammograms from the age of 30. 
• You should also consider taking yearly breast MRI starting from age 30 in addition to a mammogram. 
• If you have a family history of breast cancer, you should take a breast exam every six months starting at age 25. 
• You should perform breast self-exam every month starting at an age of 25. 

There are important differences in screening guidelines between average and high-risk women – increased frequency of tests and an early age for screening. 

The concluding note

While knowing that you have a high risk of breast cancer can be overwhelming, it also paves way for early detection. Breast cancer screening guidelines need to be taken seriously whether or not you have an increased possibility for developing this ailment. 

If you wish to learn about your risk of breast cancer, you can consult with Dr Rohan Khandelwal, breast cancer specialist at the CK Birla Hospital. 

Also, read: Breast Cancer- Screening & Diagnosis