Breast Cancer and Mammograms

Dan Frith

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Almost everyone knows someone who has had a bout with breast cancer.

The risk factors are fairly well known. Age - about 2 out of 3 women with invasive breast cancer are age 55 or older when the cancer is found. About 5% to 10% of breast cancers are thought to be linked to changes (mutations) in certain genes. The most common gene changes are those of the BRCA1 and BRCA2 genes. Women with these gene changes have up to an 80% chance of getting breast cancer. Family history is important - breast cancer risk is higher among women whose close blood relatives have this disease. White women are slightly more likely to get breast cancer than are African-American women. Women who have had not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer.

In the past most doctors recommended annual mammograms (x-rays of the breasts) starting at age 40. However, if you have one or more of the above risk factors, maybe an annual mammogram is not enough, according to the American Cancer Society.

The recommendations for screening women at risk for breast cancer include the use of magnetic resonance imaging or MRI examinations on an annual basis. This recommendation is based upon studies which showed that an MRI could detect cancers missed by mammography. One study published in the New England Journal of Medicine found that, in high risk women, MRIs detected 32 out of 45 breast cancers while mammograms only picked up 18.

My take: Demand annual MRIs exams after age 40 if you are at increased risk for breast cancer.