Question about high risk

sparrowhawk

I have a few breast issues and was talking to my mother today. She told me she has very dense breasts and a history of lumps, and that two of her relatives (her aunt and a cousin) both died from breast cancer. Another of her aunts had a very aggressive breast cancer a couple of years ago but has recovered. One of my aunts (mother's sister) had a mastectomy after calcifications were found in her breasts.

I'm just curious how doctors measure risk based on family history and if there is any significant risk for me based on this. I'm seeing a specialist on 2nd Nov and want to give her these details too.

Thanks all!

MelissaDallas

It is a complicated subject that really only a genetics counselor can tell you. Fibroadenomas aren't an issue and most of us have heterogeneously dense breasts unless we are elderly. It is really only the "greater than 75% density" by birads rating that is considered much of a risk.

I'm not sure why anyone would have a mastectomy because calcifications were found in her breasts. Most of us cevelop calcifications as we age. Calcifications themselves aren't a diagnosis

sparrowhawk

Thank you. From memory I think there was a serious issue with my aunt which warranted the mastectomy (not cancer, though), but I don't know for sure what it was and don't want to create a story. Perhaps it was preventative.

My mother seems to have more cysts than fibroadenomas, judging by what she said. And I seem to be far lumpier than she is. She was really kind and offered to send me her US/mammogram report!

MelissaDallas

60+% of women have fibrocystic breasts. It isn't much of an issue unless you have large fibroadenomas when you get older, and then just because a large one might obscure something behind it on imaging.

From what we know now only about 10% of breast cancers are genetic

sparrowhawk

Thanks! Wow, I didn't realise that genetic predisposition accounts for so few breast cancers. My mother told me her reports say dense breast tissue and cysts. I really wonder about my many lumps but I'm sure the doctor will help me with that one.

Godismystrength

I have dense, lumpy breasts. It apparently makes it hard to see some tumors. About 3 years ago, the mammogram showed calcifications in my right breast. Had to have the more detailed mammogram. The next year showed no change. Two years later, I moved, but had the images sent to the new imaging facility, and had another mammogram They didn't find anything.

Four months later, I found a lump in my right breast, which ended up being two cancerous tumors. Always do your own breast checks and report changes.

The breast surgeon suggested that I have a mammoprint done, which showed that I fall into the 'high risk of recurrence' group, and that I would benefit from chemo. The breast surgeon recommended a mastectomy, which I had.

During my four months of chemo, my oncologist suggested a DNA screening for cancer. I was found to have a CHEK2 gene mutation. My sister and daughter also were tested and had the same mutation. My niece did not have the mutation.

Now, I want to have the other breast removed for peace of mind. I wish I would have known about the gene mutation before my first surgery. I would have gone ahead and had a double mastectomy.

Make sure your insurance will cover the test before you have it done, as it can be expensive.

sparrowhawk

Thanks for this! My lump (or two lumps joined together/very close to one another...whatever they are!) measures 6cms and is visible through my skin, and I did hear from my doctor that it could hide something suspicious because of its size. I will ask the specialist more about my risk. My insurance will not cover my specialist appointment. I will get some sort of discount, but even so it will be about $130.

WC3

A lot of times they use the breast cancer risk assesment tool at cancer.gov but I will tell you first hand, it's horribly inadequate because it does not take in to account breast density, Ashkenazi heritage or paternal family history.

I always thought of my personal risk as 50/50...I estimated a hell of a lot better than the assesment tool, unfortunately

sparrowhawk

Thanks for that. Even though they can help, I'm often wary of risk assessors like that for reasons you mentioned. I checked my own risk using that tool (I put that I am 35, though I'm a bit younger) and it says I have higher than average risk.

Kerri_Oz

My first ever mammogram showed microcalcifications. That led to another more focused mammogram and then a stereotactic core biopsy. The results of that were LCIS/ALH. After that there was an ultrasound and two more biopsies. One of the biopsies showed a complex fibroadenoma. I've got dense breasts, lots of cysts, chronic inflammation (mastitis), and a host of other things that aren't a problem on their own. My mother, aunt and grandmother have all had breast cancer. It all adds up to a greatly increased risk of breast cancer, so I am having prophylactic double mastectomy, which is booked for the end of November. There are some things in life that are unavoidable, but if I can take steps to reduce at least one risk, I will do it. My boobs are often sore and tender, so I don't think I will miss them. I certainly won't miss the extra monitoring, biopsies, waiting for results and all the associated stress and worry. When I first approached the surgeon with just family history, dense breasts and mivrocalcifications, he was hesitant about surgery, but as each lot of new results came through, he got more on board with it. He is now fully supportive of my decision. (There are other factors involved, like never having had kids or breast fed, being a heavy smoker for 30+ years, etc. It all adds up).

sparrowhawk

Thanks so much (from another Aussie!). I wish you the best of luck with your mastectomy.