It is estimated that an average of one in eight women in the United States will be diagnosed with breast cancer in her lifetime (1). This makes breast cancer the most commonly diagnosed cancer for women, and the second most cancer-related death for women (1). However, thanks to early detection, better treatment options, and increased awareness, the number of deaths as a result of breast cancer have been steadily declining since 1990. In fact, there are over 3.1 million breast cancer survivors living in the United States right now (1).
Risk Factors: Family History and Genetic Predisposition
In addition to environmental risk factors, there are other factors which can increase the risk of breast cancer. There are certain genetic alterations that can increase the risk of breast cancer. The following are examples high risk factors related to family history and genetics (1):
- BRCA1 or BRCA2 gene mutation or other less common genetic mutation, such as PALB2, PTEN, CHEK2, or ATM.
- A close relative (such as parent, sibling, or child) who has been found to have a BRCA1 or BRCA2 gene mutation.
- Family history of breast cancer.
- Received radiation therapy to your chest to treat a different type of cancer, especially if you were between the ages of 10 and 30 years old.
- A personal history of breast cancer.
- Extremely heavy or unevenly dense breasts.
These factors increase a woman’s risk of developing breast cancer, and highlight the importance of genetic tests to assess your level of risk. They also highlight the importance of early detection.
Risk Factors: Environmental and other
There are various risk factors that can increase the likelihood of getting breast cancer based on the environmental. If one is aware of specific risk factors that could affect her, she will have a better chance of preventing, delaying, and/or treating breast cancer. Here are some environmental or lifestyle risk factors (1):
- Radiation to the chest
- Excessive alcohol consumption
- Lack of physical activity
- Poor diet e.g. high in saturated fat or lacking in fruits and vegetables
- Being overweight or obese, especially after menopause
Most of these risk factors can be controlled or avoided. If one notices any of them are particularly problematic, then she may want to consider a lifestyle change.
There are several ways to assess breast health for early signs of breast cancer. Here are a few ways to screen for early detection (1):
- Monthly breast self-exams feeling for:
- Changes in how the breast or nipple feels (such as increased tenderness).
- Lumps appearing or changes in skin texture.
- Changes in size or shape of a breast (unexplained by other factors).
- Any nipple discharge, if not breastfeeding.
- Annual mammograms for women 45 and older.
- Consult a healthcare provider about MRI screening in addition to annual mammograms if a moderate-high risk of breast cancer
- Visit a qualified healthcare professional to perform a breast exam if there are any concerns about physical changes to the breasts.
Who Should Get an MRI for Breast Cancer Screening?
Not everyone needs an MRI when it comes to screening for breast cancer. However, if a woman is one of the aforementioned individuals at high-risk, she may want to consider it. Breasts are more thoroughly checked when an MRI is used in addition to annual mammograms. Occasionally, a mammogram will pick up something that was missed by an MRI or vice versa. Although an MRI is generally more sensitive than a mammogram, the increased sensitivity can occasionally result in a false positive (ref). A false positive occurs when a suspected mass is thought to be cancerous, but is actually benign. This could potentially result in a situation where a woman is undergoes additional procedures to confirm the original diagnosis. (1)
Neither mammograms or MRI are 100 percent effective when it comes to early breast cancer detection, but when used together, they have the best chance of catching any signs of cancer as early as possible. Women who may be a candidate for MRI breast cancer screening and should talk to a healthcare provider to determine if it’s appropriate. (1)
What are My Next Steps?
If you have already had your MRI screening, what should you do next? If your MRI scan result is negative, and you do not have any breast cancer symptoms, most women continue with routine surveillance under the supervision of their healthcare provider. Remember, even with previous negative scans, it is important to continue routine breast exams and annual screenings for early detection in the event that there is breast cancer in the future.
In the event that your MRI result displays signs of breast cancer, work with your doctor to determine a plan of action. The most important thing to remember is that by detecting the cancer early, your chances of survival are higher than cancers detected at later stages of disease progression (1)
Hopefully this has given you a better idea the pros and cons of MRI screening for breast cancer, and a good knowledge base before talking to your doctor.
- American Cancer Society. Breast Cancer Facts & Figures 2015-2016. Atlanta: American Cancer Society, Inc. 2015.