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Risk Assessment and Risk Management for Breast Cancer

29 May 2008

Every October, a breast cancer awareness campaign is rolled out. Such campaigns can often have the unwanted effect of exaggerating the risk of breast cancer in the minds of many young women.

It is true that the life time risk of breast cancer for those lucky to live to 85 is about 1 in 10 but what does this mean for young women who have been told that they have double the risk because of a family history?

To make sense of this information, it is important to understand that the risk of breast cancer is very much age specific.

Under the age of 30, it is so rare that it really should not be a reason for excessive worry. Between the age of 30 and 50, the risk is 1/1,000 a year or 2% over the whole period. Between the age of 50 and 65 it rises to 2/1,000 a year. This risk can be modified by many factors as follows:

  • family history parity,
  • age at first pregnancy,
  • diet,
  • obesity,
  • social class,
  • alcohol consumption
  • exercise

Family history can give clues to a genetic predisposition that indicates either a very high risk, or in other cases, a much smaller risk. However with increasing knowledge, the issues of risk assessment and risk management are getting more and more complicated. As a result there are many women in the community who over-estimate their risk and can be counted amongst the worried well and a smaller number who are unaware of their risk and are missing out on the new developments in prevention and early detection.

It is for this reason, the Princess Grace Hospital is proud to announce the opening of a new service for breast cancer risk assessment/ risk management.

The service is run with the support of the latest diagnostic and computer support. The latest computer software will allow accurate risk assessment that will effectively triage the women into three risk groups: low, intermediate and high.

  • The low risk group will be offered reassurance and counselled about a healthy lifestyle.
  • At the other extreme, the highest risk group would be those from a family likely to be carrying one of the BRCA gene mutations. They would be offered genetic counselling and genetic testing. If they test positive they can then be offered intensive MRI screening or prophylactic surgery.
  • The intermediate group, as well as being offered life style advice would also be eligible for more intensive screening than standard and have an opportunity of entering the IBIS II trial for the chemo-prevention of breast cancer with one of the new aromatase inhibitor drugs.

For more information about this new service, please contact 0207 034 8890.