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Most Women Have No Idea of Their True Breast Cancer Risk Status

breast cancer, breast cancer awareness, breast cancer risk

Do you really know your risk of developing breast cancer? What do you think are the most important factors? When asked about factors that increase breast cancer risk, most women will say “family history.” While genetics does certainly play a role, more than 85% of women who develop breast cancer have no family history of the disease.

Jonathan Herman MD, of Hofstra North Shore LIJ Medical School in New York, found through surveying almost 10,000 women (aged 35 to 70) that 45% of women will underestimate their risk while around 46% overestimate. Only 9.4% of women surveyed could provide estimates that were in line with calculated risk.

Minorities such as African-American women were more likely to be on the “underestimating” side, while white women tended to overestimate. Understanding risk is crucial because it influences a woman’s participation in breast cancer screening and prevention. Even overestimating risk could be detrimental because they could be at risk of overtreatment and psychological harm, says Dr. Steven O’Day, the moderator for the American Society of Clinical Oncology where the findings were presented.

"Patients must have a better understanding of their personal risk," says Dr. Herman, saddling at least some of the blame on clinicians who do not discuss breast cancer risk with the same regularity they devote to cardiovascular disease and other potentially life-threatening conditions. “Women should be aware of their breast cancer risk number, just as they know their blood pressure, cholesterol, and body mass index.”

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The National Cancer Institute offers a Breast Cancer Risk Assessment Tool that only takes a minute to complete. Keep in mind, however, that the tool provides only estimates and should not be used as a substitution for regular health care provider visits and appropriate screening.

Questions include:
1. Do you have a medical history of breast cancer, ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS)? These increase the risk of developing invasive breast cancer.
2. What is your age? The risk of developing breast cancer increases with age.
3. What was the age of your first menstrual period? Those who had their first period before age 12 have a slightly increased risk.
4. At what age did you give birth to your first live child? Women who give birth at a younger age have a slightly decreased risk.
5. How many first degree relatives (mother, sister, daughter) have had breast cancer? Family history of the disease increases risk.
6. Have you ever had a breast biopsy? Having had a biopsy means that you have had unusual tissue changes that needed to be evaluated, including hyperplasia. The biopsy itself, however, does not increase the risk.
7. What is your race/ethnicity? African American women do not necessarily have an increased overall risk, but do have a greater risk of the disease at a younger age, tumors being found at a later stage, and an increased risk of dying from the disease.

The Breast Cancer Risk Assessment Tool will estimate a woman’s risk of developing invasive breast cancer during the next 5-year period and up to age 90 (lifetime risk). Remember that even those at a higher risk for the disease may be able to lower risk by making certain lifestyle changes, such as maintaining an ideal weight, quitting smoking, eating more fruits and vegetables, and getting daily exercise.

Source reference: Herman JD, et al "Women's understanding of personal breast cancer risk: Does ethnicity matter?" BCS 2013; Abstract 4. (Breast Cancer Symposium)

Additional Resource: The National Cancer Institute