The Doctor Is In: Breast Cancer FAQ's

Q: Am I at risk for breast cancer?

Could you get breast cancer?
No matter what your risks, you can help protect yourself from breast cancer.  Some risk factors for breast cancer - such as age - can't be avoided. On the other hand, there are some risks that you can control. It's important to be aware of the risks you can't change and those that you can do something about.

Risks you can't control

Family history. If people in your family have had breast or ovarian cancer, you may have a higher risk for breast cancer. According to the American Cancer Society (ACS), this is especially true if you have multiple close relatives who had breast or ovarian cancer, a relative who had both breast and ovarian cancer, or one or more relatives who had breast cancer before age 50.

Genes. Some gene mutations can increase your risk for breast cancer. If you inherit an altered BRCA1 or BRCA2 gene, your risk of breast cancer increases dramatically. Other genes are under study for their role in the development of breast cancer.

Testing is available for some of these genes, but the ACS strongly recommends talking to a genetic counselor, nurse or doctor with expertise in these tests before you have them done. The benefits and risks are different for every woman.

Age. After age 50, your risk of breast cancer rises sharply. That's part of the reason that yearly mammograms are recommended for all women in this age group.

Previous cancer. Having cancer in one breast increases your risk for cancer in the other breast, or for a second cancer in the same breast.

Early menarche. If your first menstrual period occurred before you were 12, your risk of breast cancer is slightly higher than women whose first period occurred later.

Late menopause. Studies show that women who reach menopause after age 55 have an increased risk for breast cancer.

Radiation therapy to the chest. Women who have had radiation therapy to the chest are at higher risk for breast cancer, especially if the therapy was given while the breasts were still developing in adolescence.

Diethylstilbestrol (DES). If your mother took DES while she was pregnant with you, you have a higher risk of breast cancer. From the 1940s to the 1960s, this drug was prescribed for some women to help prevent miscarriage.

Q: What is the optimal timing for breast self-exams?

A: The best time to perform a breast self-exam is about a week after the start of your period. That's when your breasts are least likely to be tender or swollen. Your breast tissue undergoes changes each month during your menstrual cycle. Changes in hormone levels associated with menstruation cause your breasts to swell. Once your period starts, the swelling subsides and your breasts return to normal.

During pregnancy and nursing, your breasts may feel lumpier than usual. If you have any questions about how your breasts look or feel, call your physician.

Q: What are the symptoms of breast cancer?

A: While the widespread use of screening mammograms has increased the number of breast cancers found before they cause any symptoms, some are still missed.

The most common sign of breast cancer is a new lump or mass. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But some cancers are tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.

Other signs of breast cancer include the following:

  • a swelling of part of the breast
  • skin irritation or dimpling
  • nipple pain or the nipple turning inward
  • redness or scaliness of the nipple or breast skin
  • a nipple discharge other than breast milk
  • a lump in the underarm area

Q: What is a mammogram?

A: A mammogram is an x-ray of the breast. This test is used to look for breast disease in women who appear to have no breast problems.

During a mammogram, the breast is pressed between 2 plates to flatten and spread the tissue. The pressure lasts only for a few seconds. Although this may cause some discomfort for a moment, it is needed to get a good picture.

For the mammogram, you undress above the waist. You will have a wrap or robe to cover yourself. A technologist (most often a woman) will position your breast correctly for the test. The pressure lasts only a few seconds while the picture is taken. The whole procedure takes about 20 minutes.

About 1 in 10 women who get a mammogram will need more pictures taken, but most of these women do not have breast cancer, so don't be alarmed if this happens to you. Only 1 or 2 mammograms out of every 1,000 leads to a diagnosis of cancer.

Women with a higher risk of breast cancer should talk with their doctor about the best approach for them. They may benefit from starting mammograms when they are younger, having them more often, or having other tests. If you are at higher risk, your doctor might recommend ultrasound or MRI (magnetic resonance imaging).

Medicare, Medicaid, and most private health plans cover all or part of the cost of this test. And breast cancer testing is now more available to women without health insurance for free or at very little cost through a special program called the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).