Breast Cancer Risk Assessment

Overview

A variety of factors influence a woman's risk of developing breast cancer. Knowing her estimated risk of breast cancer can help a woman choose appropriate screening and risk-reduction care. An accurate estimation of breast cancer risk can be used to place this risk in relation to general health risk factors.

The risk of developing breast cancer can be estimated in women 35 or older based on several variables. A woman's current age, her age when menses started, and her age when her first child was born are some of the factors are used to estimate risk. Clinicians in the Mayo Clinic Breast Diagnostic Center can help a woman evaluate her risk of breast cancer and decide what action, if any, is appropriate.

One aspect of breast health care at Mayo Clinic focuses on estimation of risk. Mayo Clinic has significant expertise in identification and management of women at high risk of developing breast cancer. One of the largest integrated breast practice facilities in the world, Mayo Clinic brings together the expertise — diagnostics, genetics, imaging, and prevention — to help patients understand their risk of developing breast disease. The patient-care team takes time with the patient to assess all risk factors. Following risk assessment, which may be conducted by internal medicine physicians, specialists in medical genetics and genetic counselors, patients make decisions about their care in concert with their Mayo Clinic team of health care professionals.

Risk Assessment for Known and Unknown Familial Breast Cancers

The interaction of numerous risk factors contribute to more than 90 percent of breast cancers. The remaining breast cancers occur in women who carry abnormal genes that are known to significantly increase the risk of breast cancer. These genes can be passed between generations of a family.

BRCA1 and BRCA2 are the two known breast cancer gene mutations. The presence of these genes is suspected when numerous members of a family have breast cancer, especially if the cancers affect men, several generations of the family, or occur before a woman's menopause. These genes also increase the risk of ovarian cancer.

Mayo Clinic provides detailed consultation to determine whether a patient is a candidate for genetic testing. Blood testing can be performed to learn whether a person carries the BRCA genes. Mayo Clinic genetic counselors can be very helpful in:

• Determining whether an individual might be a carrier of a genetic mutation
• Helping with the decision to obtain genetic testing
• Interpreting the test results
• Dealing with any emotional response to the test results

Familial Cancer Program

The Familial Cancer Program (FCP) at Mayo provides these detailed consultations. The standard American Cancer Society guidelines are not intended for families with a higher-than-average cancer risk. Through the FCP, individuals at greater risk for cancer receive the latest information about familial cancers, counseling and a personalized plan for cancer screening.

Consultations in the FCP are available for women who have had cancer and those who have not had cancer but have a family history of cancer. Most women with breast cancer do not have hereditary breast cancer resulting from BRCA genes, but their relatives are at increased risk for breast cancer nonetheless. Many women choose not to have genetic testing because testing is not medically indicated or by personal choice.