Do I HAVE To Have A Mammogram?

Photo by Dainis Graveris on Unsplash

What does ‘at risk’ mean? And why is assessing risk and acting based on that assessment so difficult?

I have been a physician for almost 25 years. In that time, information has become available in an instant, especially medical information. So many websites are available for people to access, yet I still spend the better part of my day explaining to patients what the statistics mean when we talk about risk. Putting these risks in perspective seems like a good idea.

The most common conversation in my practice is about risk for breast cancer. I am a gynecologist, so all my patients are women. Breast cancer is the topic that scares people the most. One number sticks in everyone’s head from some TV commercial: ‘A woman’s risk to be diagnosed with breast cancer is one in eight.’ What do those numbers really mean? If eight women are in a room, one is bound to have breast cancer? Of course not. That particular statistic means if a woman lives to age 80, then at 80, her risk is one in eight that she will have developed breast cancer by that time. That is, one of those eight women who reach age 80 will have had breast cancer. But who is the “one”?

Many things can increase the risk that a woman will be diagnosed with breast cancer during her lifetime. The list is long, and sometimes a woman has no identifiable risks yet still gets breast cancer.

Things that increase breast cancer risk:

• Being over 60
• Being overweight or obese
• Not exercising enough
• Having a family history, especially a mother, sister or daughter, that had breast cancer
• Drinking more than four 5 oz glasses of alcohol per week
• Starting periods prior to age 11, or having menopause later than age 55
• Using or taking certain types of hormone replacement for certain periods of time
• Having had radiation treatments to the chest for another condition
• Having other types of cancer like uterine or ovarian
• Smoking
• Having had breast biopsies done
• Being the carrier of a genetic mutation like…