A mammogram once a year for women aged 40-49 is still an area of debate. Most of you have had friends and family in their 40's with breast cancer so you should find interest in the results of a recent study.
What are the risk factors for breast cancer in women 40-49?
Dense breasts are the big one. Women in their 40’s with extremely dense breasts on mammography are at higher risk. A previous blog
of mine has more details on this.
In women 40-49, at least one first-degree relative (mom or sister) with breast cancer increases your risk, and if you have both (dense breasts + family history) you have at least a two-fold increased risk for breast cancer.
Risk was even higher among women with 2 or more first-degree relatives with breast cancer or first-degree relatives diagnosed before age 40 years.
The following 3 factors were also associated with a 1.5 to 2.0-fold increased risk
1. A prior benign breast biopsy result.
2. A second-degree relative with breast cancer (grandparent, aunt, niece.)
3. Heterogeneously dense breast tissue (compare this to a 2 fold increase in those with extremely dense breasts.)
Additional risk factors for women in their 40’s were current use of oral contraceptives, nulliparity (never having a child,) and first birth at age 30 years or older.
Interestingly, factors that were related to lower than average risk
in women 40-49:
1. Body mass index (BMI of 25 kg/m2 or higher) which is a surprise. BMI >25 is considered overweight. So overweight women had lower risk than normal weight or underweight women.
2. Low breast density.
3. Being 15 years or older at the age of your first menstrual cycle.
4. Birth of 3 or more children.
5. Breastfeeding (especially if 12 months or longer.)
This information helps us tailor breast cancer screening, and decide how aggressive to be with the treatment of some of our 40 year olds. Once a year mammogram, ultrasound, and the question of breast MRI should be discussed with your doctor if you are someone with these risk factors.
- Dr. O
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