Who is at high-risk for breast cancer?
If you have a greater than 20% lifetime risk of breast cancer, you are considered a high-risk patient. Your doctor can calculate your personal risk using a breast cancer risk assessment tool. These tools take into account factors such as your age, family history of breast cancer, prior abnormal breast biopsy results, and hormonal factors among others.
Other high-risk criteria include genetic mutations, such as BRCA 1 or BRCA 2, familial cancer syndromes, and a history of prior chest radiation therapy between the ages of 10 and 30 years.
The American Cancer Society recommends that all high-risk patients undergo screening breast MRIs in addition to mammography, regardless of breast density.
What if I am not at high-risk for breast cancer but have dense breasts?
If you have a 15-20% lifetime risk of breast cancer, you are considered an intermediate-risk patient. You should discuss with your doctor whether additional screening may be of benefit to you.
Currently, additional screening tests include whole breast ultrasound and breast MRI. These supplemental methods of screening may detect more cancers, but they also detect more findings that are not cancer. Patients may undergo additional imaging tests and often biopsy before finding out an abnormality is not a cancer. For some patients this may cause unnecessary anxiety, while other patients do not mind because they want a definitive answer. For this reason, you and your doctors should discuss if additional screening is right for you.
If you have a <15% lifetime risk of breast cancer, you are considered a low or average risk patient. At this time, there is no data to suggest additional screening is beneficial in low or average risk patients, regardless of breast density.