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Breast Cancer  (Expert Forum)
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Am I at greater risk?
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

Am I at greater risk?

by LuLu66, Feb 18, 2002 12:00AM
I'm a 35 year old female whose had 5 breast biopsies in the last five years.  They have all been benign thus far, but every time I have a mammogram they find something new to biopsy.  My breat surgeon and I have finally agreed to a biannual breast exam and to wait until I'm 36 for another mammogram.  My last biopsy was a stereotactic Bx which caused a hemmorhage into the left breast.  After 1 year I'm left with a golf ball sized nodule(?hematoma) which makes the breast exam more difficult.  I had been okay with  this plan until recently.
     My mother, age 59, has a very suspicious area on mammogram and is having a biopsy next week.  If it turns out to be malignant, how worried should I be about my chances of getting breast cancer.  Do they do prophylactic mastectomies?  Am I a candidate?  I try not to worry but it is hard everytime I find another lump.  I will be discussing this with my surgeon on my next visit.  In the meantime, I'm looking for some advice.  Thank you in advance.

by CCF-RN,MSN-JS, Feb 18, 2002 12:00AM
Dear Lulu, Having a family history of breast cancer (mother or sister) puts one at a moderately higher risk of breast cancer than the average woman.  This risk increases if the relative had breast cancer prior to menopause or if the cancer was in both breasts.  There is also noted higher risk to those carriers of a familial breast cancer gene, BRCA1.  Women who've had a previous cancer in one breast, especially if it occured before menopause are at significantly higher risk.  Other risk factors include early onset of menstruation and late onset of menopause, women who have never carried a term pregnancy or who were first pregnant after 30, obesity with excess caloric and fat intake.

The determination of a person’s individual risk is complex.  Attempts have been made to quantify risk using various model’s for example the Gail model which assigns certain number values to risk factors and calculates a person’s risk based on age and a calculated risk number is given.   This is only a tool, which can only tell a person their statistical risk based on its criteria.  It cannot tell if you actually will get breast cancer.  

Prophylactic mastectomy is done in certain situations for high risk women.  The decision to pursue this option would involve determination of individual risk, and discussions of risk vs. benefit in the individual's own situation.
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