Breast Cancer Prevention and Screening

Keeping breast cancer at bay in San Diego

A middle-aged woman gets a mammogram to detect breast cancer.

Keeping breast cancer at bay in San Diego

Women born in the United States have a 1 in 8 chance of being diagnosed with breast cancer. While doctors and researchers don’t completely understand the causes, they do know women can reduce their risk in several ways.


To learn more, continue reading below about risk factors, breast cancer prevention and screening, and the benefits of early detection.

Causes, risks and family history

Causes, risks and family history

According to the American Cancer Society, breast cancer is the second leading cause of cancer death in women. That’s why, at Scripps Cancer Center, we encourage you to learn as much as possible on breast cancer causes, risks and family history.

Breast cancer begins when the cells in the breast start to grow out of control. The majority of breast cancers start in the ducts that carry milk to the nipples or in the glands that produce breast milk. But the cause of such growth is not completely understood. IBC symptoms are caused by cancer cells blocking lymph vessels, but the cause is not known.


Doctors do know that imbalances in the female hormones estrogen and progesterone play a role. Family history also may play a role if an inherited gene mutation is passed down from relatives.

Breast cancer risk factors can be categorized as controllable and non-controllable. It’s important to note that many women with risk factors never develop the disease. And some women who have breast cancer have no known risk factors.


Controllable breast cancer risk factors


Alcohol consumption

Women who have two to three alcoholic drinks per day have about a 20% higher risk of breast cancer than women who do not drink. Having one drink is linked with a very small increase in risk.


Weight

Excess weight, especially after menopause, raises breast cancer risk. After menopause, most of a woman’s estrogen is produced by fat tissue, so the more fat tissue a woman has, the higher her estrogen level, which can raise risk. Women who are obese also may have a higher risk of inflammatory breast cancer.


Physical activity

Women who are physically active have a lower risk of breast cancer than women who are not active.


Children

Women who have not had children, or had their first child after age 30, may have a higher risk for some types of breast cancer.


Hormonal birth control

Use of birth control methods that contain hormones may increase a woman’s risk. The risk appears to return to average within five to 10 years after discontinuing birth control.


Combined hormone therapy

Women who use hormone replacement therapy after menopause may have a higher risk of breast cancer if their therapy combines estrogen and progesterone. This risk is not seen with estrogen-only therapy, but women who use only estrogen have a higher risk of endometrial cancer. The increased risk of breast cancer from combined hormone therapy appears to return to average within five years of discontinuing use.


Non-controllable breast cancer risk factors


Gender

Breast cancer is about 100 times more common among women than men.


Age

A woman’s risk increases with age. Most breast cancers are diagnosed in women age 55 and older.


Race

Inflammatory breast cancer is more common among African-American women than women of other races.


Inherited gene mutations

About 5% to 10% of breast cancers are hereditary, meaning they’re caused by a genetic defect inherited from a parent. The most common inherited mutation is in the BRCA1 or BRCA2 gene. There are other breast cancer gene mutations, but they’re less common, and most don’t increase the risk as much as BRCA gene mutations.

Genetic testing can identify mutations in BRCA1, BRCA2 and other genes that may raise your risk of breast cancer. If you or a family member has a higher than average risk of breast cancer due to a personal or family history of cancer, a suspected genetic mutation or other factors, Scripps genetic counselors can provide information, counseling and recommendations, and assist with referrals for genetic testing.


Our genetic counselors are health care professionals with specialized graduate training in medical genetics and counseling. Find out more about genetic testing for breast cancer at Scripps.

Breast cancer risk reduction

Breast cancer risk reduction

Breast cancer cannot be completely prevented, but you may be able to lower your chance of developing it by taking steps to:


  • Reduce your controllable risk factors
  • Increase protective factors


If you have risk factors that you cannot control, such as a family history of breast cancer, talk with your physician about additional ways to reduce your risk.

The following protective factors may help reduce the risk of getting breast cancer.


  • Avoid alcohol.
  • Maintain a healthy weight.
  • Exercise at least four hours per week.
  • Reduce estrogen levels by breastfeeding.
  • Discuss risks of hormonal birth control or hormone replacement therapy with your physician.
  • If you’re at high risk, discuss risk-reducing mastectomy or treatments to reduce the amount of estrogen.

Benefits of early detection

Benefits of early detection

Early detection of breast cancer — when it’s still small and hasn’t spread beyond the breast — can be easier to treat and lead to a more successful outcome. According to the American Cancer Society, the five-year relative survival rate for women with stage 0 or stage I breast cancer is close to 100%.

Preventive screening

Preventive screening

Breast cancer screening can help find breast cancer in its early stages, even before any symptoms appear. It’s important to have regular screenings to detect and stop breast cancer in its tracks. Mammography, which compresses the breast between two plates and then takes X-ray images, is the most common screening exam for early detection of breast cancer. 


Scripps recommends the following breast cancer screening exams.


Age 20 to 39


  • Clinical breast exam every one to three years with a health care provider who checks for lumps or other changes


Age 40 and older


  • Clinical breast exam every year
  • Mammogram every year


Women at increased risk

If you have risk factors for breast cancer, your doctor may recommend that you begin screening sooner, have additional tests or get screened more often.


If you have breast implants or have been told you have dense breast tissue (which means you have less fat tissue in your breasts), you may need additional screening. Your physician will let you know what you need.

Scripps Cancer Center is renowned for breast care in San Diego. Reasons why include:


  • All Scripps locations provide state-of-the-art digital mammography, which uses lower doses of radiation than conventional mammography and produces clearer, high-resolution images of breast tissue to detect potential abnormalities at their earliest stages.
  • All mammograms are read by physicians specializing in breast imaging.
  • Every screening mammogram is double-checked by a computer-aided detection system for ensured accuracy.
  • Scripps mammography centers are accredited by the American College of Radiology.


In addition to mammography, Scripps offers screening MRI, ultrasound and other exams.


Scripps provides breast screenings and mammography services at more than a dozen Scripps Health locations in San Diego County, as well as our three dedicated specialty breast care centers.

Screening mammograms are preventive digital imaging exams that look for lumps or other change in the breasts. These tests are performed on women who do not have signs of breast cancer, and are designed to detect changes before they are able to be felt or seen.

If a screening mammogram or physical exam finds something unusual, the next step is usually a diagnostic mammogram. These focus on the area in question, capturing images from various angles and magnifying them. The diagnostic mammogram may determine that the breast tissue is actually normal, or it may lead to further diagnostic testing.

Scripps also offers three-dimensional mammography, or tomosynthesis, which provides 3D images of the breast. This allows the radiologist to view each layer of breast tissue, which is especially helpful for women who have dense breasts.

Magnetic resonance imaging (MRI) for breast cancer screening can help detect abnormalities in women who have dense breast tissue, breast implants or other conditions that may affect the accuracy of mammography. MRI scans also can help detect breast cancer in women whose risk is very high, such as women who have a family history of breast cancer.

Ultrasound is an imaging procedure that uses sound waves to create pictures of the breast tissue. A wand-like instrument is moved over the breasts to send sound waves into the tissue, and the images are then recorded and displayed for review. Ultrasound is often used after mammography to clarify results or obtain more information.