Breast Cancer Risk Management

Breast cancer risk management means establishing your individual level of risk and building a screening and prevention plan around it. The same screening programme is not right for everyone: family history, genetics, breast density and hormonal history all change which test is used and how often.

What Determines Risk?

• Family history: breast or ovarian cancer in first-degree relatives
• Genetics: inherited changes in genes such as BRCA1 and BRCA2
• Breast density: dense tissue both raises risk and lowers the sensitivity of mammography
• Hormonal history: early menarche, late menopause, later age at first birth
• Previous biopsies: lesions showing atypia
• Lifestyle: weight, alcohol intake, physical inactivity
• Radiation history: chest radiotherapy at a young age

Screening According to Risk

For women at average risk, regular mammography from a defined age is the basis of screening. In high-risk groups screening may start earlier, be performed more frequently, and include breast MRI in addition to mammography. Where breast tissue is dense, ultrasound has an important complementary role. Your individual plan should be decided with your doctor after a risk assessment.

Reducing Risk

• Weight control and regular physical activity
• Limiting alcohol intake
• The protective effect of breastfeeding
• Deciding on menopausal hormone therapy according to individual benefit and harm
• Considering risk-reducing medication and genetic counselling in selected high-risk individuals

Who Should Consider Genetic Counselling?

Genetic counselling is considered when there is breast cancer at a young age in the family, bilateral breast cancer in one person, male breast cancer, an association with ovarian cancer, or cancer in several close relatives. Testing should follow a discussion of what the results would mean for you and your family.

Frequently Asked Questions

There is breast cancer in my family, will I get it too?

Family history raises risk but is not a certainty. A substantial proportion of breast cancers occur in women without any family history. What matters is defining your risk and building the right screening plan.

At what age should screening start?

For women at average risk it generally begins around the age of 40. Where there is early-onset cancer in the family, screening may start years before the youngest age at diagnosis.

My breast tissue is dense, what should I do?

In dense breasts mammography alone may not be sufficient; ultrasound and, in selected cases, MRI are used as complementary tests.

Is self-examination enough?

Self-awareness matters but does not replace screening. If you notice a new lump, nipple discharge or skin retraction, you should be assessed without waiting.

Should I have a genetic test?

The decision follows an assessment of your family history and personal risk profile. Counselling before and after testing is needed for the result to be interpreted correctly.

Consultation

For an individual risk assessment and a screening plan that fits you, you are welcome to get in touch.