Searches for breast cancer signs increased by up to 300% the day after actress Olivia Munn revealed her diagnosis. Searches for breast cancer risk assessment tools, such as the one Munn used, increased as well.
Munn urged all women in an Instagram post to ask their healthcare doctors to evaluate their risks using these tools, which are readily available to the general public online. However, breast cancer risk assessment quizzes aren’t the only technique to detect cancers early. Experts discuss breast cancer risk assessment tools and tests, as well as signs to look for.
What Are the Breast Cancer Risk Assessment Tools, and How Do They Work?
These tools are essentially calculators, except instead of numbers, they utilize information from your medical history, family health history, age, race, reproductive history, and, in some circumstances, height and weight to predict your breast cancer risk.
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There are several tools available, but the two most widely used are the Breast Cancer Risk Assessment Tool (BCRAT, formerly known as the “Gail Model”) and the International Breast Cancer Intervention Study (IBIS) model, previously known as the Tyrer-Cuzick Risk Assessment Calculator. Both are available online and completely free to use.
The BCRAT “tends to underestimate the risk a little because it is very simple and doesn’t have a lot of different things you have to answer,” says Dr. Jason Mouabbi, a breast oncologist at MD Anderson Cancer Center, to Yahoo Life. However, he claims that the IBIS tool overestimates dangers. This is due to the need for additional information. Mouabbi employs both methods to obtain the most accurate picture of a person’s risks.
The IBIS tool calculates your risk of acquiring breast cancer in the next ten years and over your lifetime, whereas the BCRAT tool calculates your five-year and lifetime risks (up to age 90). Both tests should only be used by adults.
A lifetime risk score of 20% or above (as estimated by the IBIS model) indicates significant risk. Using the BCRAT test, a five-year risk of more than 1.66% is considered high. However, there are some key caveats and considerations to keep in mind while interpreting those ratings, as well as other relevant aspects and symptoms.
Important Information to Consider Before Using Breast Cancer Risk Assessment Tools
First and foremost, have your healthcare professional conduct your assessment for you. “You don’t want to do it wrong, because it can lead to unnecessary anxiety,” Mouabbi said. These risk assessment quizzes are well-known among oncologists, but any healthcare professional can assist you in taking one.
Second, the instruments may not be as accurate for younger people. The BCRAT calculator specifies that it should only be used to determine the risks for women aged 35 to 85. The IBIS model does not specify an age limit, but Mouabbi says he only uses either calculator to determine hazards for those beyond the age of 30.
Most importantly, these evaluation methods should only be used by those who are at “average” risk of developing breast cancer. According to the American Cancer Society (ACS), women in the United States have a one in eight chance of developing breast cancer.
However, when utilizing a risk assessment tool, the difference between an average and a high risk of breast cancer is determined by whether or not someone has tested positive for mutations in the BRCA genes, which have been linked to an increased risk of breast cancer.
Discover Your Family History and Genetic Risk
One of the most critical measures you can take to better understand your breast cancer chances, whether or not you use an assessment tool, is to learn about your family’s health history, which plays a significant role in risk calculation.
If you choose to use a risk assessment tool on your own, “you should try to talk to a health care provider to see if you’ve used the right risk assessment test based on your family history,” Susan Brown, a registered nurse and senior director of health information and publications at the Susan G. Komen Foundation, tells Yahoo Life.
The majority of persons who acquire breast cancer have no family history of the disease. However, having a first-degree family with breast cancer, such as a sister, mother, or daughter, puts a person at nearly double the risk of developing it themselves, according to Breastcancer.org.
A few genes and genetic variants, such as BRCA1 and BRCA2, have been linked to an increased risk of breast cancer. Because breast cancer appears to run in families other than these genes, experts believe there are additional genetic components that have yet to be uncovered, implying that family history is an important risk factor even if you know you do not possess these mutations.
People who have these mutations, as determined by genetic testing, are already at high risk and should take safeguards rather than depending on risk assessment quizzes, according to Mouabbi.
“Those mutations do not skip generations,” he points out. “Someone in the family will already have had it.” A family history of breast cancer is a strong reason to undergo BRCA testing, which can cost between $250 and $5,000 but may be covered by insurance.
According to the Centers for Disease Control and Prevention, approximately one in every 500 women in the United States carries a mutation in either the BRCA1 or BRCA2 genes. These mutations are thought to increase the risk of breast cancer by four to seven times and put carriers at a 10% to 46% increased risk of ovarian cancer.
However, according to Brown, “all people are at risk for breast cancer — even men get breast cancer.” Even if risk assessment tools and genetic screening findings do not “raise any red flags,” she says, “it doesn’t mean they shouldn’t talk to their health care provider” about screening and prevention.
What to Do Once You’ve Identified Your Risk
If your risk of breast cancer is less than 20%, your doctor would likely encourage you to follow normal screening guidelines and receive mammograms every year beginning at age 40.
If you’ve had a mammogram, radiologists can tell you if you have thick breasts and need further screening. Whatever your score is, keep in mind that it varies over your life, so if you score under 20% one year, don’t assume you’ll be low-risk the next, warns Mouabbi.
Those who score 20% or higher should begin receiving more frequent and extra screenings, such as MRIs and ultrasounds, which can help discover breast cancer instances that are frequently overlooked by mammography. The good news, according to Mouabbi, is that having a high-risk score should automatically require your insurer to cover additional screening, which can be costly.
It also qualifies you for preventative care, he explains. Some women at high risk of breast cancer may be offered tamoxifen; the estrogen-blocking medicine is used to treat breast cancer at large levels, but it can also be taken at lower doses to cut chances by 43%, according to a University of Toronto study.
Understand the common symptoms of breast cancer—and your body.
Knowing your risk based on quiz results might help you and your doctor develop effective screening and preventative methods. However, Brown points out that there is no alternative to merely knowing and paying attention to one’s own body.
Experts, including the United States Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS), no longer suggest routine breast self-exams because monitoring for lumps has not been found to enhance survival rates for women with breast cancer. However, there is still value in people “knowing what’s normal for them,” adds Brown, and paying attention when anything changes. This entails keeping a look out for:
Changes in the size or shape of one or both breasts:
- Changes in the size or shape of one or both of your breasts
- Skin dimpling (which can make your breast look as if it has a texture like an orange peel)
- Pain in your breast or nipple
- A nipple turning inward
- Red, flaky, dry, or thick nipple or breast skin
- Nipple discharge
- Swollen lymph nodes (usually under the arm or around the collarbone)
“If you notice a change in your breast or underarm, do not sit at home and wonder about it, do not consult Dr. Google; go see your health care provider,” said Brown. According to the American College of Obstetricians and Gynecologists (ACOG), half of women over 50 and 70% of women under 50 are diagnosed with breast cancer after noticing a change on their own.
“Most people who find a change in their breast don’t turn out to have breast cancer,” Brown said. “But those changes are found when women are just going about their daily lives — showering, dressing, or a partner finding a change — so women need to know those warning signs and be conscious of changes in their bodies.”
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