Breast risk assessments in Salt Lake City, Utah
The Breast Risk Assessment (BRA) Initiative at St. Mark’s Hospital provides personalized breast cancer screening plans for women in Salt Lake City, Utah.
For more information or to schedule your breast cancer risk assessment, please call (801) 268-7900.
Breast cancer screening guidelines
Historically, the suggested age to begin screening mammograms was 40 years old. However, there are now conflicting age recommendations from various organizations, ranging from 40 to 50 years old.
An important thing to note, however, is that the organizations supporting a later age for screening mammograms also support the opportunity for women to make a personal, informed decision to begin screening earlier.
|1||American College of Radiology||Annual screening mammograms beginning at age 40|
|2||National Comprehensive Cancer Network||Annual screening mammograms beginning at age 40|
|3||American College of Obstetricians and Gynecologists||Annual screening mammograms beginning at age 40|
|4||American Cancer Society||Women should have the opportunity to begin mammograms at age 40 with annual mammograms beginning at age 45|
|5||U.S. Preventive Services Task Force||Women should have the opportunity to begin mammograms at age 40 with mammograms every other year beginning at age 50|
The BRA Initiative
The varying recommendations for screening mammograms create confusion among women and the medical community. St. Mark’s created the BRA Initiative to help women understand their own risk for breast cancer and to help reduce the confusion through education and shared decision making.
The BRA Initiative is designed for women around 40 years old who have not yet begun regular screening mammograms. Women who have a BRA consultation will create a personalized breast screening plan with a St. Mark’s provider, based on the woman’s individual breast cancer risk and her personal preferences for screening.
Your BRA consultation
During a BRA consultation, you will complete a personal and family history information sheet and have a mammogram to check for abnormalities in the breasts and evaluate breast density. (Breast density refers to the appearance of breast tissue on a mammogram. Higher breast density increases a woman’s risk for breast cancer.)
This information is analyzed with risk assessment tools, and your individual breast cancer risk is determined. Using your BRA results, our Women’s Center in Salt Lake City will develop an individualized breast cancer screening plan with you. A genetic consultation is available if your BRA results indicate possible hereditary risk.
Women are considered at high-risk for breast cancer if their five-year risk is 1.7 percent or greater, or if their lifetime risk is 20 percent or greater
Breast cancer risks
It is important to realize that the guidelines for screening mammograms only apply to women who are at average risk for breast cancer. That is why it is so important for women to understand their own risk. That is the major goal of the BRA Initiative.
Screening guidelines do not apply to women with breast cancer symptoms, such as a lump, focal pain, nipple discharge or other breast concerns. If you are experiencing any concerning symptoms or changes in your breasts, contact your doctor immediately.
- Increasing age (risk increases across all ages until about 80 years old)
- Certain inherited genetic mutations (BRCA1 and BRCA2 are the most well-known). Five to 10 percent of breast cancers result from inherited mutations.
- Family history of relatives with breast or ovarian cancer; particularly if first degree relatives were diagnosed at an early age
- History of high-dose radiation to the chest
- Having dense breasts
- Ashkenazi (Eastern European) Jewish heritage
- Certain breast changes found on biopsy
- Beginning menstruation before 12 years old
- Starting menopause after 55 years old
- Alcohol consumption
- Post-menopausal hormone replacement use (containing estrogen and progestin)
Benefits and limitations of breast cancer screenings
The most powerful benefit of regular screening mammography is that it reduces a woman’s chance of dying from breast cancer by about 30 percent.
Another major benefit is that it reduces the necessary breast cancer treatment for many women by finding cancers earlier.
Since the aim of mammogram screening is to find all possible breast cancers, any potential abnormality seen on the mammogram is usually evaluated with additional work-up and sometimes a biopsy. This means that women may experience anxiety and discomfort during this work-up process and may not ultimately have breast cancer. This is a limitation called “false positive.”
In addition, it has been suggested that some breast cancers, if left alone, would not be life-threatening. At the present state of medical knowledge, there is no way to tell which cancers may not be life-threatening, so all breast cancers are treated. This is a limitation called potential “overtreatment.” Also, mammography does not detect all breast cancers. This is a limitation called “false negative.”
Some women are also concerned about the radiation exposure from mammograms. Mammograms require very small doses of radiation (about the same amount of radiation as a Salt Lake City resident receives naturally from the environment and cosmic radiation in five weeks). The risks of this amount of radiation are exceedingly low.