Knowing your personal risk of breast cancer can be lifesaving, but what does “risk” really mean? Risk is the chance that something can happen, and in this case, it’s the chance that you may develop breast cancer in your lifetime. While everyone has some level of risk, some people, due to their genetics, family history or other factors, have a higher chance than others.
Understanding your personal risk can empower you to take proactive steps, like actress Olivia Munn, whose risk assessment score changed the course of her care. She had no warning signs or symptoms and received clear mammogram results, but a risk assessment during a routine doctor’s visit prompted additional imaging. Following a breast MRI her team detected aggressive breast cancer in both breasts that may have otherwise been missed. Olivia’s story underscores how some risk assessment tools may help find what other tests might not. In this blog, we’ll help you navigate these tools, understand mitigation strategies and take action to protect your health.
“There’s a lot of things that you need to know in your life. Your social security number—and your percentage of getting breast cancer in your life.”
— Olivia Munn, Real Pink Podcast Listen Here
What factors can increase your risk?
Several factors can increase risk of breast cancer including:
- Family history of breast, ovarian or prostate cancer or having an inherited gene mutation
- Previous breast biopsies showing atypical hyperplasia
- Early menstruation (before age 11) or late menopause (after age 55)
- Never having children or having children later in life
- Use of menopausal hormone therapy
Breast cancer risk assessment tools
Breast cancer risk assessment tools help estimate your likelihood of developing breast cancer within specific time frames, such as within your lifetime or the next 5-10 years. Health care providers use these tools to personalize care and make informed decisions. For example, they may recommend starting screenings tests earlier or screening with a breast MRI in addition to a mammogram.
The Gail Model is ideal for women at average risk –typically those who do not have a strong family history of breast cancer or known inherited genetic mutations. It is most accurate for women 35 years old and older, and it estimates risk in the next 5 years and the lifetime risk of breast cancer. It evaluates factors including age, pregnancy history, history of breast biopsies and immediate family history of breast cancer. Health care providers often use the Gail Model for guiding general screening recommendations like deciding when to start annual mammograms.
The Tyrer-Cuzick Model, also known as IBIS, is a risk assessment tool that is designed for people at higher risk based on their family history with relatives that have breast or ovarian cancer or for individuals that have a BRCA1 or BRCA2 inherited gene mutation. It incorporates a wider range of factors such as breast density, family history including second-degree relatives, and the likelihood of carrying BRCA gene mutations. This model is commonly used in specialized high-risk breast clinics to develop detailed, personalized risk management strategies.
There are also risk calculators designed with more specific populations or risk factors in mind:
The BWHS (Black Women’s Health Study) Breast Cancer Risk Calculator is based on data from Black women in the U.S. and uses personal and family health history along with reproductive history to estimate risk.
The Breast Cancer Surveillance Consortium (BCSC) Risk Calculator factors in your personal and family health history, reproductive history and breast density to estimate risk.
Your risk has been assessed; what’s next?
The next steps depend on your risk level:
- Average risk: Begin annual screening mammograms at age 40. Discuss the results with your doctor.
- Higher risk: Discuss the results with your doctor. They may recommend additional screening like a breast MRI or mammograms earlier than age 40. They may also explore further measures like risk-reducing medications, lifestyle adjustments or preventive surgery. A helpful question to bring to the table is: Based on my risk score, should I consider additional screenings or risk reducing options?
Lifestyle choices that can help lower your breast cancer risk include:
- Regular physical activity and exercise
- Maintaining a healthy weight
- Limiting alcohol consumption
- Limit menopausal hormone therapy (postmenopausal hormone use)
- Breastfeed if you can
Just like Olivia Munn, knowing your breast cancer risk could be the difference between routine screening and a potentially lifesaving intervention. Her story reminds us that risk assessment tools don’t just provide numbers; they hold powerful information that may aid in early detection. No matter your risk, taking charge of your breast health begins with understanding your normal and discussing it with your doctor for any next actionable steps. Your risk percentage isn’t fate; rather, it’s a call to advocate for your care and wellness.
Olivia Munn’s story on Real Pink Podcast describing how risk assessment saved her life: Part I Part II
Downloadable (PDF) Resources:
Breast Cancer Risk Factors View PDF
Genetics and Breast Cancer View PDF
How Hormones Affect Breast Cancer Risk View PDF
Risk Lowering Options for Women at Higher Risk of Breast Cancer View PDF
Risk and Screening Resources:
Questions for Your Doctor About Risk
Risk and Family History:
