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If you have a family history of breast cancer, when should you start receiving mammogram screenings?

By May 8, 2009 - 12:20pm
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I have a very strong family history of breast cancer. On my father's side it has affected every woman for three generations. Unfortunately, I am the next woman in the lineup. About a year ago, I asked my doctor how early I could get a mammogram screening; I am currently 22 years old. She told me they usually are not recommended until you are in your 30's and most insurance companies recognize this. I followed up with my insurance and they actually do not even cover mammograms until a woman is over 30. They suggested maybe receiving an ultrasound. How important is to for me to get either a mammogram or ultra sound at 22 with a very strong family history of breast cancer?

In relation to this, I also have heard various information about soy products and their correlation to breast cancer in women. I have soy products everyday due to my lactose "unfriendly" stomach. I consume various milk alternative such as, soy yogurt, soy milk, and soy protein. How important is it to avoid these products?

I would appreciate any opinions, suggestions, or advice on this subject.

Thank you!

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HERWriter Guide


One more thing I wanted to say was to take into account the risks of genetic testing like the BRCA tests. These are financial risks. You do risk being denied life insurance, health insurance or even employment, even if this is not legal (especially with regard to employment). Health records are not as confidential as we think, despite HIPAA rules regarding patient privacy.

I know several breast cancer survivors (in their 30s) who are denied life insurance. Those with positive BRCA results can face the same dilemmas.

We never want to think that these issues will dictate our proactivism with our health care but I just want to let you know the real life consequences some people have paid for genetic testing.

Our health is a very complicated issue because it affects so much else in our lives.

But the more information you have, the better! The 'empowhered' patient is the one most likely to have a better outcome.

May 9, 2009 - 10:26am
EmpowHER Guest

I also come from a long history of breast cancer survivors and I had my first mammogram at age 25 since I am at a high risk to develop it. I tend to have them done every five years until I reach 40, than every year.

The most important thing is to check yourself weekly, monthly, whatever you feel comfortable with. If you have any question as to whether you may have something questionable, see your physician immediately. It is important to find something early.

Another good thing is with young breasts, we tend have have much denser tissue and a mammogram may not be able to detect something. An ultrasound may be better in detecting any abnormalities so don't be discouraged.

Genetic testing of course usually isn't covered by insurance but may be good just for early detection. I have not done it myself but I do check weekly for any abnormalities. I hope this adds to what Susan has already suggested. Keep us posted.

May 9, 2009 - 9:35am
HERWriter Guide

Hi Shana - thanks for the update!

I am not sure on the stats of how many women elect to get a mastectomy once they get a positive result. I know some do (I have read their accounts) and others use a positive BRCA result to engage in extra vigilance.

EScience News did a report on this very topic - you can find it here : http://esciencenews.com/articles/2009/03/09/women.with.brca.mutation.or.worry.most.likely.undergo.prophylactic.mastectomy
It's such a personal decision that everyone has their own reason to elect mastectomies, or not, as the case may be.

The American Cancer Society has a guide to doing your own breast exams - and don't feel silly that you don't know how - none of us do - unless we are taught!

Here is the link : http://www.cancer.org/docroot/CRI/content/CRI_2_6x_How_to_perform_a_breast_self_exam_5.asp

and here is an instructional video :

I hope this helps!

May 9, 2009 - 4:36am

Thank you very much for all of the information, It is extremely helpful. It is confusing since there are so many different opinions on which options are the best. I do agree that a BRCA test would be beneficial, although it is very scary to me. The thought of it being negative with a chance of still getting breast cancer, seems unsettling. And what if it is positive? Do the majority of women elect to getting mastectomies?

I do not know how old each family member was when they were diagnosed with breast cancer, so I will take that as my first step. Is it even clear how concerned I should be about my own fate? I understand there are so many variables to every individual situation. I am kind of a worry wart about even small concerns.

I will also try to avoid soy, because I would not want to increase my risk. There are so many studies out there it is difficult to fully trust one over another. I mean one day red wine is good for your health and another it has been shown to increase the risk of cancer in women.

It may sound silly to actually admit, but I have never been taught how to give myself a proper breast examine. I mean I have seen the diagrams in my doctor's office and familiar with the motions, but am unclear of what I am exactly looking for. I understand I want to make sure there are no lumps, but how can you tell a small lump from just simply breast tissue? It actually seems quite embarrassing to admit that at almost 23 years old, but true nonetheless.

May 8, 2009 - 3:11pm
HERWriter Guide

Hi Anon

Thanks for your question and for sharing your rather difficult dilemma with us.

Several doctors have told me that they believe a woman should start mammograms 10 years before the age their relative was upon diagnosis. in other words, if your mom was 40 when she was diagnosed, you should start testing at age 30. This isn't a 'rule' of course, but many doctors think it's a good idea.

In terms of mammograms, you will hear various pros and cons for them. Many women have had cancerous lumps detected via mammograms - even as young women. Others have been diagnosed with breast cancer even though a mammogram showed nothing at all.

People worry about the radiation involved in mammograms.

Another issue for you to consider with mammograms is that the younger you are, the denser your breast tissue is and makes finding a lump quite difficult.

Other people prefer ultrasounds; I know someone who found a lump that a subsequent mammogram didn't find - but a ultrasound did. This person (a medical doctor herself) is a great believer in ultrasounds to detect breast cancer.

With regard to eating soy - there has been much speculation, as you said, as to soy and it's relationship to breast cancer.
Some studies of Asian women (who traditionally eat soy as part of their regular diet) and who traditionally have low incidences of breast cancer, lead many to believe that eating soy was beneficial to breast health.

However, since soy produces estrogen-like properties and since an increase in estrogen is a risk to getting breast cancer, it has also been said that women should hold off on eating a lot of sow (generally about 40 grams or more everyday). Studies have shown a weak link (but a link, nonetheless) between soy consumption and breast cancer but further, long-term effects could not be concluded.
It must also be said that it's thought that these 40 grams more of soy may be risky, rather than the lesser amounts that, for example, Japanese women have in the average diet (less than 15 grams).

Don't forget that self breast exams are crucial for you. Many women find their own lumps themselves.

Have you considered getting a BRCA test? This is the test that can determine your genetic risks for getting breast cancer. A positive result is not a guarantee of getting cancer of course, not is a negative result a guarantee that you will not get it.

You may have read stories of women who are very high risk who got positive results and elected to have mastectomies. This is a huge decision that a woman would need to make, after much thought and consultation. BRCA tests are considered most important for women under 50 whose family members were under age 50 when they were diagnosed with breast cancer.

I know you have many decisions to make. Since you have such a strong, documented history of breast cancer in your family, your insurance may actually cover some or all of this testing. Make sure your doctor documents your family history when giving your referrals. With some insurance companies, this does make a difference in their decision whether to cover you or not.

And lastly, make sure you maintain a healthy, fresh diet and exercise regularly - don't drink more than two alcoholic drinks a day (max) and don't smoke.

Has this helped you? I know it's a ton of information all at once but I hope you can figure out what to do that's right for you. I know how hard it is to have a family history and have these fears live with you.

Tell us how we can help you more, if you need it!

May 8, 2009 - 1:03pm
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