Breast cancer risk assessment: high risk

This leaflet is for women with a high risk of breast cancer (following a family history risk assessment). This information has been produced by Guy’s and St Thomas’ NHS Foundation Trust and East Kent Hospitals’ Breast Cancer Nurse Specialists.

If you have any queries, please contact the:

• Breast Cancer Risk Assessment Service
  Telephone: 01227 868666
  Email

What is a high risk of breast cancer?

Breast cancer is a common disease. In the general population about one in eight women in the UK will develop breast cancer.

What about genetic testing?

Only about 5 to 10% of all breast cancers happen because of an inherited tendency (also called a genetic predisposition). If you have a high risk of breast cancer then it is possible, but by no means definite, that the cancer in your family could be caused by an inherited tendency.

Genetic testing is offered to some families with an increased risk of breast cancer, depending on the exact details about the family tree.

If genetic testing is possible, this begins by looking for a gene fault (‘mutation’) in a relative who has breast cancer. This is called diagnostic genetic testing, or a ‘mutation search’ genetic test. Genetic testing may still be possible if your relative has died. Genetic testing can be discussed with your genetics doctor or genetic counsellor.

Do women with a high risk of breast cancer need breast screening?

Yes. Screening for women with a family history of breast cancer is based on nationally recommended guidelines. These can be found on the National Institute for Health and Clinical Excellence website.

Current guidelines recommend that women with a high risk of breast cancer have mammograms once a year from 40 to 59 years old. Women with an exceptionally high risk of breast cancer may be eligible for breast screening under the age of 40.

For most women with a high risk there is no evidence that screening before the age of 40 is helpful, even if your relatives have had breast cancer before this age. Also some young women have breast tissue that is too ‘dense’ (tightly packed) for a mammogram to produce clear images.

From age 60 to 70 you will be offered mammograms every three years, like all other women in the UK. You will not need mammograms more often than women in the general population because:

• breast cancer is easier to see on a mammogram after the menopause; and

• if breast cancer does occur, it is likely to grow more slowly in women aged 50 or over.

Women over 70 can request that their breast cancer screening continues every three years, if they wish.

For more information, please ask a member of staff for a copy of the NHS breast screening: helping you decide leaflet.

All women are encouraged to be breast aware. Contact your GP if you notice any changes in your breasts. Please do not wait until your next mammogram.

Can anything alter breast cancer risk?

Yes, the following can alter the risk.

• The oral contraceptive pill and hormone replacement therapy (HRT) slightly increase the risk of breast cancer while a woman is taking it, and for up to five years after it is stopped.

• Alcohol increases the risk of breast cancer.

• Pregnancy and breastfeeding lower the risk of breast cancer.

• Being overweight increases the risk of breast cancer for women after the menopause.

• Regular exercise lowers the risk of breast cancer.

• Eating plenty of fresh fruit and vegetables, and lowering cholesterol intake helps lower the risk of cancer.

• If anyone else in your family develops cancer, particularly breast or ovarian cancer, then this could alter your risk. If this happens, please ask for a reassessment of your risk.

Useful contacts

• Breast Cancer Now
  Telephone: 0808 800 6000

• Macmillan Cancer Support
  Telephone: 0808 800 0000