No Family History? Breast Cancer Screening Still Matters
October is Breast Cancer Awareness Month, when pink ribbons are everywhere, and mammogram reminders are hard to miss. But one of the most important messages may also be one of the easiest to overlook: You don’t need a family history of breast cancer to be at risk.
In fact, only a small percentage of breast cancers, likely 10 percent or less, are linked to hereditary conditions. Most women who develop breast cancer do not have an inherited genetic cause.
That’s an important misconception to clear up, says Brittany Hipkins, MD, MPH, a Blue Ridge Health family medicine physician who sees patients at the Sylva Health Center and Blue Ridge Health Swain.
“Breast cancer is the most common cause of cancer in women, and the majority of cases of breast cancer are not genetic,” Hipkins said. “This is why there are population-based recommendations for every woman to get screened for breast cancer.”
Knowing when to begin screening can be confusing. Recommendations have changed in recent years, and organizations including the U.S. Preventive Services Task Force, the American College of Obstetricians and Gynecologists, and the American Cancer Society have somewhat different guidelines.
The U.S. Preventive Services Task Force, whose recommendations family medicine providers commonly use, recommends that women at average risk begin screening mammograms at age 40 and continue every two years through age 74. But “average risk” is an important distinction. Family history is one factor that can affect an individual woman’s risk, along with other factors to discuss with her healthcare provider.
Another common misconception is that there is no reason to get a mammogram if you don’t feel a lump or notice anything unusual.
But that is precisely the point of screening.
“The point of any screening test is to find any abnormalities as early as possible, when they are most treatable and before things progress,” Hipkins said.
Some changes also shouldn’t wait for a regularly scheduled mammogram. A new lump in the breast or underarm area, new nipple discharge, or a new rash on the breast should be evaluated by a healthcare provider. And when something simply doesn’t seem right, Hipkins encourages women to have it checked.
“We would always rather see someone for a concern, even if it’s something normal we can reassure them about, than wait until something has progressed,” she said.
Some women have concerns about mammograms themselves, including radiation exposure or the possibility of additional tests or procedures that ultimately prove unnecessary. Hipkins notes that screening recommendations are developed by weighing those potential risks against the benefits. For most women at average risk, evidence shows that the benefits of regular mammograms beginning at age 40 outweigh the potential harms.
For women with questions about their individual risk, when to begin screening, or whether mammography is right for them, a conversation with their healthcare provider is a good place to start.
And during Breast Cancer Awareness Month, it’s a conversation worth extending beyond ourselves to the women we care about. No family history does mean no risk. Feeling healthy does not mean screening can wait. Mammograms are intended to find breast cancer before there is something to feel.
Early detection saves lives, and sometimes the appointment we make when nothing seems wrong is the one that matters most.