While most women are aware that having a family history of breast cancer increases their risk of developing the disease, the fact remains that as many as 75% of women newly diagnosed with breast cancer do not have any specific risk factors, other than being a woman. Approximately one in eight women will develop breast cancer over her lifetime.
Many risk factors cannot be controlled, such as family history, age at menarche (first period), and age at first pregnancy. However many more risk factors can be controlled - knowledge is key! Lifestyle factors such as regular exercise, maintaining an ideal body weight, a diet low in saturated fat, and moderation in alcohol intake (one drink or less per day for women) will help reduce the risk of developing breast cancer.
Evaluation of your risk using a risk-assessment model will help put your concerns in proper perspective. While a risk-assessment model is not a crystal ball, many women overestimate their risk - a comprehensive review of the factors that you can and cannot change will help us develop a plan for surveillance and early detection that is appropriate for you.
The OncoVue is a relatively new test, and is an exciting addition to the risk-assessment consultation. Unlike BRCA gene testing (see below) which is primarily for women with a strong family history of early breast cancer, the OncoVue is meant for all women. Test results are reported as standard, moderate, and high-risk. Unlike risk assessment computer models, the OncoVue result gives us important information about an individual patient's risk of developing a breast cancer, and knowing that risk will allow us to develop a more tailored prevention, monitoring and testing program. It is a simple saliva test, and results are generally available within 2-3 weeks. The majority of insurance carriers do cover the test, and we are proud to be one of the few facilities in our area to offer this test to our patients.
In selected patients, I will recommend the HALO Breast Pap Test. It is an FDA-approved, noninvasive method of screening for atypical (abnormal) cells in the milk ducts. The development of atypical cells in the milk ducts is a risk factor for the future development of breast cancer. The significance of the HALO Breast Pap Test is that it is a simple, noninvasive method to evaluate cellular changes in fluid found in the milk ducts – changes that may occur many years before a lump is felt or changes are noted on a mammogram or ultrasound. If abnormalities are noted, intervention can occur much earlier, before a cancer has even developed. This test is clearly an advance in breast cancer risk assessment for young premenopausal women, often not included in routine screening guidelines, and is indicated for asymptomatic (healthy) women ages 25-45.
Depending on your specific family history, you may be a candidate for BRCA gene testing. BRCA stands for BReast CAncer Genes 1 and 2. A mutation in one of these genes will lead to a significantly increased risk of breast and/or ovarian cancer, as well as some other cancers. Using a saliva test, it can be determined if you are a carrier for one of these mutations - this information can be very important in determining the appropriate imaging and treatment options. Dr. Attai will review your history and will discuss whether BRCA testing is appropriate for your case.
