American Cancer Society Recommends New Breast Cancer Screenings for At-Risk Women

A new study confirms detection efficacy of dual screening via a yearly magnetic resonance imaging (MRI) in addition to the traditionally-recommended mammogram. In early 2007, the American Cancer Society released its new recommendation that women at a high-risk of breast cancer receive both an annual mammogram and MRI. However, the new guidelines only recommend the combined treatment for women in the high risk category.

According to the press release, a recent study comparing MRI, mammography, and ultrasound in 171 women with a high lifetime risk of breast cancer, MRI proved best at finding cancer. The study found "of the six cancers diagnosed, MRI detected all six, mammography only two, and ultrasound only one. Only MRI detected the four cancers found in women with dense breast tissue."

For most woman over age 40, an annual mammogram and clinical breast exam is still the recommended method to catch early-stage breast cancer. The primary reason for this differentiation is that regular use of MRI would lead to too many false positives and unnecessary biopsies as the sensitive technology picks up any abnormal tissue, whether cancerous or not.

Defining High-Risk

A woman is defined as at high-risk for breast cancer if she meets at least one of the following conditions:

She has a BRCA1 or BRCA2 mutation. According to data from the American Cancer Society, "the BRCA1 and BRCA2 genes are tumor suppressor genes. When they are mutated, they no longer function to suppress abnormal growth, and cancer is more likely to develop."

She has a first-degree relative (parent, sibling, child) with a BRCA1 or BRCA2 mutation. In these instances, she is treated as high-risk even if she has yet to be tested because mutations in these genes can be inherited.

Her lifetime risk of breast cancer has been scored at 20%-25% or greater. This risk assessment is based on one of several risk assessment tools that look at family history and other factors.

Other factors include radiation to the chest between the ages of 10 and 30 or having Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome.

Lowering Your Risk

The American Cancer Society report, Breast Cancer Facts & Figures 2007-2008, details the four major risk factors over which women have control: weight, exercise, alcohol use, and second hand smoke.

Studies have shown that weight gain during adulthood and obesity increases a woman's risk of postmenopausal breast cancer. Similarly, exercising vigorously for 45 to 60 minutes on 5 or more days per week can lower a woman's risk of breast cancer. Postmenopausal women can lower their risk with any level of physical activity performed on a regular basis. Women who drink two or more alcoholic beverages per day face a 21% increase in their risk for breast cancer. The link between secondhand smoke and breast cancer remains controversial because most studies have found no link between cigarette smoking and breast cancer, but there is some evidence of a connection.

The study is reported in the October issues of Harvard Women's Health Watch. Additionally, the new MRI guidelines and full details of the risk groups can be found in the March/April 2007 issue of CA: A Cancer Journal for Clinicians.

Sources:

Newswise

American Cancer Society, Do We Know What Causes Breast Cancer?

American Cancer Society, Breast Cancer Facts & Figures 2007-2008

CA: Cancer Journal for Clinicians