Breast awareness and self examination are emphasized beginning at age 20. I encourage patients to be aware of any masses that are the size of a frozen pea or larger and present for greater than 3 weeks. It is important to cover the entire breast up to the collar bone and also the lymph nodes in the arm pits. Self breast exams are best done one week after your period and in the shower. Self examinations are relevant because 70% of breast cancers are detected by self exams in patients less than 50 years old. Clinical breast examinations performed by a physician should occur every 1-3 years according to the patient and physician preference between the ages of 20-39 and annually at age 40-75.
What factors make a person more at risk for breast cancer besides family history? Some of those risks include : first pregnancy after age 30, menarche (first period) before age 12, late menopause (after age 55), no pregnancy carried to delivery, no breast feeding, alcohol abuse, and smoking.
Screening mammograms should begin yearly at age 40 according most of the academic societies. The incidence of breast cancer predicts that it will affect the lives of 1 in 8 women. Women with more than a 20% or greater lifetime risk qualify for "Enhanced Screening". Enhanced screening includes clinical breast examination every 6 months, annual mammogram, annual MRI, and directed systematic self examination.
BRCA 1 & BRCA 2 genetic screening is easier than ever before. It can be done as easily as using a mouthwash kit and in your physician office. The test is appropriate for those who have a 1st degree relative with a breast cancer diagnosis before age 50, those who have any member with ovarian cancer, those with 2 or more 2nd degree relatives with breast cancer at an early age, those with a family member with male breast cancer, those with a family member with bilateral breast cancer , and those with a known BRCA positive family member. The test is completely covered by most insurances and can help empower you to make decisions. Some of those include determining which program for screening is right for you, determining the timing of your next pregnancy, deciding whether or not to undergo egg cryopreservation (freezing for the future), or deciding to undergo preventative mastectomy.