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Maybe you’ve had a close family member diagnosed with breast cancer. Or maybe you’re too young for mammograms, so you haven’t considered your breast cancer risk. Either way, now is a good time to find out if you’re at a high risk of developing breast cancer.

Learn whether you’re at a high risk and what that means for breast cancer screenings throughout your lifetime.

How Do I Know if I’m High-Risk for Breast Cancer?

The best way to know whether you’re at a high risk of breast cancer is to talk to your doctor about potential breast cancer risk factors and have a breast cancer screening. Screening means checking for signs of diseases like breast cancer before symptoms appear. The purpose of screening is to detect cancer early, when treatment is most effective.

The most common screening tests for breast cancer are:

• Screening mammograms — These x-rays of breast tissue are the best screening tests for early detection of breast cancer.
• Breast ultrasounds — Used to examine areas of concern found on mammograms.
• Clinical breast examinations — Physical exams by health care providers to check for lumps or breast changes.
• Breast MRIs — Provide detailed images of breast tissue using magnets and radio waves, often recommended for high-risk women.

If you’re too young for regular screening mammograms or you haven’t discussed your breast cancer risk with your provider yet, you can take some actions now that’ll help you when you do.

Know your breasts

Take notice of how your breasts feel and look from different angles. Report any breast changes to a health care provider right away. Changes can include dimpling, discoloration, nipple discharge, nipple inversion, or other differences.

Know your personal and family health history

If your mother, sister, or daughter has a history of breast cancer, your recommended screening plan could change. It might move you up into a higher risk category. Tell your health care provider about any first-generation health changes that could affect your cancer risk.

If you have a family history of breast cancer or other risk factors, consider discussing genetic testing (such as testing for BRCA mutations) with your health care provider. This testing analyzes your risk level and guides decisions about screening and prevention.

Calculate your estimated risk

Many doctors use the Gail Model to help estimate a person’s risk of developing invasive breast cancer throughout their lifetime. The model is fairly accurate in predicting cancer risk for women who have no prior history of cancer themselves.

The National Cancer Institute (NCI) offers a user-friendly version of this tool based on the Gail Model. The tool uses personal information to calculate breast cancer risk, including:

• Age.
• Age at first period.
• Age at delivery of first live child.
• Number of first-degree relatives (mothers, sisters, daughters) with breast cancer.
• Number of prior breast biopsies.
• Other demographics.
• Presence of atypical hyperplasia on biopsy.

The model creates an estimation of your risk of developing cancer in the next five years and over your lifetime. You can use this calculator tool to estimate your breast cancer risk and print out your results. Though the tool is particularly accurate for white women, it may underestimate risk in others, so consider that when calculating your risk.

The estimate isn’t a substitute for recommendations from your health care provider. Rather, you should use it as a starting point for a discussion with your health care provider about your risk.

At What Age Should I Start Breast Cancer Screenings?

The following are breast cancer screening age recommendations from UPMC Hillman Cancer Center and UPMC Magee-Womens for those at average risk of breast cancer:

For average risk women:

• Women under 40 should make sure they’re familiar with their breasts and report breast changes.
• Women ages 40 and older should get a mammogram every year.

Dense breasts can make it harder to spot cancer on screening tools. If you have dense breasts, it’s especially important to stay on top of your screenings and to follow up with your health care provider if you have any concerns or questions.

What are the breast cancer screening guidelines for high-risk women?

A woman is high-risk if her lifetime risk of breast cancer is greater than or equal to 20%.

Screening and annual mammogram guidelines are different for high-risk women.

• Starting at age 30, women at high risk should get screened annually with a breast MRI along with a mammogram.
• High-risk women as young as age 25 should talk to their doctors about starting screening breast MRIs and screening mammograms as early as age 30.

What screening options are available for younger women?

The most effective way to screen for breast cancer when you’re too young to begin regular screening mammograms is to know your breasts and note any changes. We call this “breast self-awareness.”

The most frequent sign is a new lump or mass in the breast. This is often hard and painless, but can sometimes feel soft, tender, or painful. Younger women are more likely to have benign (noncancerous) lumps, but any lump might mean cancer regardless of age.

The most common cancers in young adults (ages 20 to 39) aren’t unique to this age group but differ from those in children or older adults. Most breast cancers occur in older adults. And though breast cancer can occur in young adults, it’s rare before age 30.

As women age, the likelihood of developing breast cancer increases. Among young adults diagnosed with breast cancer, those diagnosed at an older age tend to have better outcomes.

Early detection leads to early treatment, so report any lump or breast change to your doctor.

Can I get screened if I don’t have insurance?

Yes! Many organizations offer access to low-cost or no-cost mammograms and other breast cancer screenings.

In Pennsylvania, the PA Breast & Cervical Cancer Early Detection Program (PA-BCCEDP) is a free breast and cervical cancer screening program of the Pennsylvania Department of Health. If you meet its requirements, you may receive mammograms, breast MRIs, follow-up tests, and other reproductive health screenings. You may also have access to patient navigation services at low or no cost.

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) also provides free and low-cost breast and cervical cancer screening services for uninsured or underinsured people. You can find breast cancer screening programs in your area on the Centers for Disease Control and Prevention (CDC) website.