Definition: HIGH RISK
We know that being a woman and aging are risk factors in developing breast cancer. However, there are certain factors that can increase a person’s risk of developing the disease – more so than just the average woman.
According to the Canadian Breast Cancer Foundation, if a person has one (or a combination) of these 4 characteristics they are considered “high risk:”
- Is a confirmed carrier (has been genetically tested) of BRCA1 or BRCA2 gene mutations
- Is a first degree relative (parent, sibling, or child) of a confirmed BRCA1 or BRCA2 carrier
- Has a family history of breast cancer (usually multiple family members)
- Has a personal history of high levels of radiation exposure to the chest (ie/ radiation therapy for Hodgkin’s lymphoma)
What’s the deal with BRCA1 and BRCA2?
Everyone has these genes. In fact, they are actually designed to protect us from developing breast and ovarian cancers. However, when there is a mutation in the gene, DNA repair doesn’t happen as it should – leading to the overproduction of cells (or cancer). This kind of mutation can be inherited from maternal and paternal sides of the family.
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2You aren’t doomed
Women with BRCA1 or BRCA2 gene mutations have a 40-85% chance of developing breast cancer in their lifetime. However, only 5-10% of breast cancer cases are the result of hereditary/genetic factors. What does this mean? It means that being high risk does not give you a 100% guarantee of developing breast cancer. Rather, the term “high risk” is a classification that medical professionals (and the women and men in question) can use to increase their understanding of the situation and to take preventative measures, if necessary.
If you are high risk or you know someone who is, don’t freak out. This knowledge takes you one step closer to being in charge of the decisions surrounding your breast health. Find out about the preventative measures that high risk individuals can take below!
3What can you do?
Speak to your health care provider
If you are unsure about your breast cancer risk or think you might be high risk, the first thing you can do is speak to your health care provider. From there, you can be referred to a genetic counsellor.
Genetic counsellors help you understand what your risk of breast cancer is. With the counsellor’s help, you will be assessed depending on your medical and familial history. From there, it can be decided if you are eligibe for genetic testing.
Genetic testing occurs as a blood or saliva test to determine if you have any genetic mutations that could predispose you to breast cancer (like BRCA1 or BRCA2).
Preventative treatment options for high risk women
- Risk-reduced surgery (AKA preventative mastectomy): the removal of one or both healthy breasts
- Chemoprevention: the use of drugs to reduce risk in healthy individuals
Ultimately, every choices is yours to make. While, the preventative treatments mentioned above are the most impactful in reducing breast cancer risk, they aren’t for everyone. Other basic steps you can take to try to reduce your risk every day are:
4Screening is your friend
According to Cancer Care Ontario, women who are high risk only make up 1% of the general population. However, high risk women tend to develop more aggressive breast cancer and at earlier ages. As such, breast screening for these individuals is very important.
It is important that you check what the screening guidelines are in your province/state. However, if you are a high risk woman living in Ontario, you may be eligible for the Ontario Breast Screening Program (OBSP), which uses a combination of MM/MRI screening for high risk women ages 30 to 69 in hopes to “improve their quality of care, ensuring that they receive the benefits of screening and promote the early detection of breast cancer.”
The National Comprehensive Cancer Network (NCCN) has created a series of screening recommendations depending on the type of risk factor(s) you possess. See the full chart here and speak to your health care provider about the screening options available to you.
5You are your best advocate
As a high risk young women, you are you best advocate. It’s unfortunate, but don’t be surprised if your concern gets shrugged off with the all too familiar response: “You’re too young to get breast cancer.” If you think you might be high risk, advocate for yourself. Ensure your health care provider speaks to you seriously about your risk and get the referral you need. Again, no one is guaranteed to get breast cancer. But, you have the right to be informed about your breast health so you can make the decisions that feel right for you.