We recently had a presentation from the breast cancer/ genetic screening doctor from University of Utah at one of our OB dept. meetings. I learned a few interesting things I'd like to share, especially because I never have posted on breast cancer or ovarian cancer.
First of all, there is a fairly new law called GINA I believe. It stands for Genetic Information non-discrimination act (I believe). This law prevents insurance companies from declining insurance to you based on known genetic mutations that have caused or may cause in the future cancers, etc. This is especially important for women with a significant family risk cancer for breast cancer. We are now encouraging you to get the BRCA genetic screening test so you are aware of how at risk you may be for breast cancer and ovarian cancer as well, if you are positive for this mutation. Although it may be psychologically stressful for you to know this information, it may also be useful for to get more thorough screening such as MRI yearly for breast cancer versus just mammography. Also, if you choose to undergo a mastectomy or oopherectomy (removal of ovaries), you may be able to prevent breast and/or ovarian cancer all together. I found it quite interesting that by removing ovaries alone, breast cancer risk is reduced as much as 68%! This is due to the decline in hormones...which has it's downfalls too, but is better than getting breast cancer:) If you undergo mastectomy, your risk is reduced by 90%. Of course this is not a desirable option for some, but it is certainly something to consider in women with a strong hereditary risk and a + BRCA test.
It is important to note that regardless of family history, everybody in the general population has an 8% risk of breast cancer and this is why we encourage mammograms yearly starting at age 40. We also encourage monthly self breast exam. This entails feeling the entire breast for lumps that feel hard, non-tender, and do not move easily. It is also important to look at the breast and note any changes in skin appearance, or uneven hanging of the breast, or the nipple pulling to one side. If you have any of these changes you should see your healthcare provider right away.
It is typical to note breast tenderness and even some lumpy, mobile tissue at times such as with your menstrual cycle, or with breast feeding. Some women have fibrocystic breast tissue that feels lumpy and may require ultrasound or biopsy to decipher benign from a malignant lump.
We also recommend yearly clinical breast exam in which your healthcare provider palpates your breasts for worrisome lumps or changes. It helps to have someone trained in recognizing normal changes and typical breast tissue from worrisome changes that necessitate further evaluation.
Well, good luck with your screening exams, and as always, come in and get examined and ask questions if you are concerned about your own risks!
