With a family history of breast cancer, when's the best time for me to get my first mammogram?

Question

2 years ago both my mother and aunt (her sister) got diagnosed with breast cancer. My mother was 55 at the time and my aunt was 59. The only other case of breast cancer in my family was my great-grandmother who died of it at the age of 44. So it's obvious that there might be a stronger likelihood of my chances of the disease as well. After seeing what my mother and aunt had to go through, I've become wholly aware of this cancer and am not sure when's the best time to start being proactive with my breast health.

I'm 25 years old and don't know when's the best time for me to get my first mammogram. I've heard that 40 is the typical age, but should I be more towards getting one at 35? or even possibly 30?

Unfortunately, the highest rate of breast cancer in the US is located on Long Island, NY and sure enough, that's where myself and my family are all from.

I'm scared to what my possibilities are for getting breast cancer and don't exactly know what's the best method of early detection and prevention.

Any advice would be so helpful. Thank you.

Answer 1

Are you sure that the breast cancer in your family is hereditary?

Breast cancer that runs in families is rare - only 5 - 10% of breast cancer cases are hereditary. And with one in nine women developing  breast cancer at some time in their lives, it isn't unusual for two or more women in the same extended family to have non-hereditary breast cancer.

Also, as with other cancers, breast cancer that is diagnosed after the age of 50 is less likely to be hereditary.

The two known faulty genes that are responsible for hereditary breast cancer are  BRCA1 and BRCA2; you would be at significantly increased risk of breast cancer only if your mother carries one of these two rare faulty genes, in which case you would have a 50% chance of having inherited it, although inheriting it would not mean you would definitely get breast cancer.

You will be encouraged  to start mammograms earlier than usual even if your mother doesn't carry one of the genes, to be on the safe side - ask your doctors advice as to when.

What you should be doing is looking into whether the breast cancer in your family is due to a faulty gene; your doctor can advise you about genetic testing - it is your mother rather than you who would be tested first if it was considered advisable, because if she doesn't test positive, you wouldn't either.

This link from breastcancer.org  tells you what the criteria are for having genetic testing.

http://www.breastcancer.org/risk/genetic...

This is a fantastic site, and you can find much information on hereditary breast cancer there, including when a daughter should start screening if her mother tests positive for a BRCA gene.

Good luck

Edit** I have re-read my answer a number of times and I'm not sure what I said to merit two 'thumbs downs'. Everything I've said is factual and I directed the asker to a site that could answer all her questions, though the first answer - posted at the same time as mine - is much more thorough and informative.

Ah well.. I reserve my TDs for spam, offensive answers and  downright wrong answers, but we're all different.

Interestingly, when I was told that my breast cancer was not hereditary I was also assured that my first-degree relatives - my sisters, I have no daughters - were not at increased risk because of my diagnosis.

Answer 2

I would suggest that you talk with your doctor and get his/her recommendations after you explain your family history and your concerns.  Ask him to be directed to a genetic counselor who can explain everything - there is alot of information which can easily be confused as it depends on your particular family history, age at diagnosis, etc, etc.  

With that said, my doctor recommended that I start getting mammograms at age 30 and do monthly breast self exams because my mother had breast cancer.  She said it is important to have a clean baseline mammogram to compare any changes against it with future mammograms.  My mother was diagnosed with breast cancer at age 49 and at age 62 in the opposite breast....and my great Aunt (my mothers Aunt) was also diagnosed with breast cancer before 50 and then ten years later developed it in the opposite breast as well....also another one of her relatives died from ovarian cancer in her later years.  Due to our family history, my mother was tested for the genetic breast cancer genes BRCA1 and BRCA2 to see if she was a carrier of this gene mutation.  The test came back negative...which means that she didn't have the breast cancer gene and therefore could not have passed it down to me so there was no need for me to be tested.  However, the genetic counselor was very quick to mention that just because we don't have this genetic mutation, that doesn't mean I am out of the woods and I should be adamant about checking for lumps and getting my annual mammograms.  He mentioned that just because there are only two genetic breast cancer mutations they have identified (which we don't carry) and test for, there is still a chance that there are other breast cancer genetic mutations that have not been identified yet and therefore are not tested for.  Also, he stated that anytime your mother has breast cancer, that automatically puts you in a higher risk category regardless of whether or not you have the BRCA1 or BRCA2 gene.  Basically, he wanted to make sure I get checked and not look at the negative BRCA test as a get out of cancer free card.  As I'm sure you know, early detection is very important.

EDIT>>>I wanted to add something....If your family tests negative for the BRCA1 and BRCA2 genetic mutation, your risk of developing breast cancer is still doubled simply because your mother has breast cancer.  If you have two first degree relatives (mother, sister or daughter) with breast cancer then your risk is increased five fold.  Here is the article from ACS which details breast cancer risks.  It discusses family history factors as well as BRCA genetic mutations.  http://www.cancer.org/docroot/CRI/conten...

Here is another article with a little further clarification on BRCA testing - http://www.breastcancer.org/risk/genetic... .  It states that if your family CARRIES THE GENE and you do not - then your risk is about normal.  However, if your family TESTS NEGATIVE AND YOU TEST NEGATIVE and you have a family history of breast cancer (particularly at a younger age) then affected members may have an inherited genetic abnormality that has not yet been identified.  In this scenario, it is suggested you have start mammograms at age 25 or 10 years before the earliest age at which a family member was diagnosed—whichever comes first.

Answer 3

i was diagnosed with breast cancer at 38 years old, my mother 9 months after me was diagnosed at the age of 64, my daughter is now 28 she self examines,and has ultrasounds, but i also have 4 sisters who 9 years after my diagnoses, are still clear thank goodness and they have mammograms annually go to you doctor or cancer clinic they will advise you as to the best thing for you.good luck and keep healthy

Answer 4

With the relatively young ages of breast cancer diagnosis in your family, especially the young age of your great-grandmother, you want to get genetic testing.

Are your mother and your aunt sitll living?  If so ask one or both of them to get tested for the BRCA gene mutation.  This would really help to assess their risk of more breast cancer and other cancers (such as ovarian) as well as your risk of cancer.  After they get tested, if your mother's results are positive, you can see a genetic counselor and get tested as well.

If their results are negative you can still see a genetic counselor to discuss your risks of cancer.

It would be good if you knew at what age your great-grandmother was diagnosed.  Was she on the same side of the family as your mother and aunt?  

Generally you should start getting screened at 10 years younger than the age of the youngest person in your family at your diagnosis.  Since we don't know what age your great-grandmother was at diagnosis, presumably, you might want to start 10-15 years before her age at death, so around 29-34 years old.

You don't want to just get a mammogram, though.  You should get an MRI and possibly an ultrasound.  A MRI is what found Christina Applegate's cancer very early.  Also, it's never too early to start giving yourself breast exams every month.  If you aren't sure how to do, have your doctor show you.  You also might want to get a breast surgeon and health care team on your side now so that if you run into any concerns they will be ready to help you right away.

I hope this helps.  I'll post some links for you below in order of relevance and importance.  The first one is a great organization dealing with genetic cancers and what are called "previvors" such as yourself, who do not have cancer but have a higher risk of getting it.

Congratulations to you for empowering yourself with the information you need to make the best decisions for your health!