When You Have A Family History Of Breast Cancer

Brittany Rozema paid close attention to her body, primarily because of her family history of breast cancer.

Both her mother and aunt were diagnosed in their mid-40s with the disease that claimed her great-grandmother's life.

The Dyer, Ind. woman often asked her doctors about a lump she felt in her breast. They told her it was related to her menstrual cycle, a likely explanation for a woman her age. Noting her family history of breast cancer, doctors advised her to start getting annual screening mammograms at 35.

Last year, Rozema discovered a lump in her armpit and decided to go to urgent care for a second opinion. The provider ordered a diagnostic mammogram and ultrasound due to her dense breast tissue. The ultrasound discovered multiple masses in her breasts. Further testing revealed the 32-year-old had breast cancer.

"Everybody always used my age as a factor as to why I couldn't have breast cancer, yet you continue to hear more and more stories of all these younger women (being diagnosed)," she said. "What does it hurt (to get tested)?"

One year after her urgent care visit, Rozema is cancer-free. She had a double mastectomy and chemotherapy and will take an oral chemo drug for two years to prevent the cancer from returning. Providers at Franciscan Health Cancer Center Munster are monitoring her closely.

The Link Between Family History And Breast Cancer

With her strong family history of breast cancer, Rozema knew she was at higher risk for the disease. Unfortunately, her care providers didn't think "breast cancer" when she told them about the lump in her breast because they thought she was too young to worry about that.

The fact is that a family history of breast cancer increases your risk. One out of four women diagnosed with breast cancer has a family history of the disease. According to the American Cancer Society, having a first-degree relative (mother, sister or daughter) with breast cancer almost doubles your risk. Having second- or third-degree relatives with breast cancer also increases your risk.

Other common risk factors for breast cancer include:

• Age. Most breast cancers are diagnosed after age 50.
• Genetic mutations, specifically a BRCA1 or BRCA2 gene mutation. Women with one of these mutations are at higher risk of developing breast or ovarian cancer. They are also more likely to get these cancers at a younger age (under 45).
• Reproductive history. If you started your period before age 12 or started menopause after 55, you are at higher risk.
• Dense breast tissue, which make it difficult to see a mass on a screening mammogram.
• A family history of ovarian cancer
• Previous radiation therapy to the chest area

The Centers for Disease Control and Prevention provides a complete list of factors that increase your breast cancer risk.

What To Do If You Are At High Risk For Breast Cancer

If you have a family history of breast cancer, talk to your primary care provider. They can help you understand your risk of developing the disease. Your primary care provider can suggest tests and screenings for you to consider. Annual screenings and genetic testing are often at the top of the list.

The Role Of Breast Cancer Screenings For Women At High Risk

According to the American Cancer Society, women who are at high risk for breast cancer should get a breast magnetic resonance imaging (MRI) test and a mammogram every year, typically starting at age 30. For women at average risk, the recommendation is to get a yearly screening mammogram starting at age 40.

Sheela Konda, MD, PhD, breast imaging radiologist at Franciscan Health Munster, said after a woman has a mammogram, she should read the report to find out if she has dense breasts. Those with dense breast tissue should advocate for additional screenings. Dr. Konda explained that looking through dense breast tissue for a suspicious mass is like trying to find a snowball in a snowstorm.

Learn about mammography screening at Franciscan Health.

The Role Of Genetic Testing And Counseling For Breast Cancer

Many women with a family history of breast cancer (or other cancers) choose to have genetic testing. They want to learn whether they have a BRCA1 or BRCA2 mutation or another mutation that raises their risk.

If you are interested in genetic testing, the first step of the process is to meet with a genetic counselor. At the appointment, you will discuss:

• Your medical and family history
• Your risk of developing cancer
• What genetic testing involves and what you could learn from it

If you decide to proceed with genetic testing, the genetic counselor will meet with you when your results are ready. The counselor will explain what the results mean and your options for managing your risk.