A breast oncologist, herself at high risk for breast cancer, talks options

I am a breast oncologist — and I am a woman at high risk for breast cancer.

I am a breast oncologist — and I am a woman at high risk for breast cancer. My mother was diagnosed with breast cancer at age 41 and is a breast-cancer survivor of more than 20 years. (I won’t say exactly how long, Mom).

A woman may be at high risk for breast cancer based on her family history, genetic mutations such as BRCA1 and BRCA2, or by having a history of certain types of benign breast changes, such as atypical hyperplasia.

Women at average risk for breast cancer can start annual screening with mammography at age 40, as recommended by the American Cancer Society. However, for some women who may be at high risk, screening should start sooner. Women who think they may be at high risk for breast cancer should talk to their physicians about the appropriate breast cancer screening. This may include mammograms and sometimes breast MRIs. Depending on family history, a referral to a genetic clinic can be helpful.

I was planning to start my own breast cancer screening 10 years prior to mother’s diagnosis, but I was pregnant with my first child and then nursing. I decided to wait until several months after I stopped breastfeeding. Before that time rolled around, something happened. I felt a lump. My mind yo-yoed from being convinced that this was a clogged milk duct to being certain that it was cancer. But there was one thing I knew I needed to do, without a doubt. I contacted my doctor immediately and quickly had a mammogram and ultrasound. Thankfully, my lump turned out to be benign.

It is important for a woman to be familiar with her breasts to know what is normal — and what is not. Touch them, feel them, say hello in the shower standing up and in bed lying down. Know what is normal, and if there is a change, bring it to your provider’s attention right away. Warning signs can include a lump or bump in the breast or armpit, swelling, warmth, redness, heaviness, nipple discharge, nipple retraction (pulling in), dimpling, thickening or shape change of the breast.

Breast cancer prevention is very important too. Living a healthy lifestyle by maintaining a healthy weight, eating healthy foods, exercising and limiting alcohol intake can reduce the risk of breast cancer. For certain high-risk women, the same hormone-blocking oral medications used to treat many patients with breast cancer can lower the risk of developing breast cancer. Some women with genetic mutations, such as BRCA1 or BRCA2, may consider prophylactic surgery (mastectomies to reduce the chance of being diagnosed with breast cancer or removal of ovaries to reduce risk of ovarian cancer).

I try to eat my veggies and stay active by jogging, practicing yoga and playing tennis (Is there a level below beginner?). And this month, I also did my high-risk breast cancer screening.

Dr. Agrawal is a medical oncologist at Norton Cancer Institute


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