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By Gaelyn Scuderi, M.D.

09/24/2018

One Size Does Not Fit All: Individual Risk & Breast Cancer Screening (Part 1)

One of the aspects of my practice as a radiology physician that constantly amazes me is how very uniquely each one of us is made.  Sure, our lungs, heart, brain, and gut all have similar functions – breathe, circulate, think, digest - but it never ceases to surprise me that the organs and tissues you and I both need to sustain life look very different when compared side-to-side, person-to-person on an imaging test like a CT scan, MRI, or mammogram.  These anatomic dissimilarities are identifiable not only with the naked eye, but also at the cellular level, under the microscope.  This cellular individuality is manifest in the unique ways our cells are organized, communicate with each other, and within the genes inside our cells. 

The rapidly expanding field of genomic medicine is an exciting frontier in oncology medicine and cancer imaging that uses these genetic differences to positively impact your health care in a tailored, individual way.  Gene-specific cancer treatment plans are a good example of this technology in action.  Another important way genomic medicine influences oncology practice is by identifying patients that are at increased risk for developing cancer in the future.  If we can know as early as possible who is at risk for a certain type of cancer, then we can take action to increase surveillance for early signs that the disease may be developing, and nip it in the bud before it blooms.

As a woman physician taking care of other women, I am moved by the profound effects of breast cancer daily.  I cannot emphasize enough how common this disease is, but I also want you to know that this disease is survivable when found in its early stages by breast imaging.  Women often seem surprised to learn that up to 75 percent of women of diagnosed with breast cancer have no identifiable risk factors for the disease.  For all these reasons, it’s so important to have a yearly screening mammogram.  But what if you have higher than average lifetime risk?  Do you know what your risk factors are for breast cancer?  Should you be having the same annual mammogram as your girlfriend, sister, or coworker?   

Substantial research has been undertaken in the last decade to apply the concepts of genomic medicine to women and breast cancer.  These efforts have revealed that women at higher than average risk may need to have more than just an annual screening mammogram.   This research has also uncovered the fact that higher than average breast cancer risk isn’t just limited to those patients who have undergone genetic testing or who have a family member with breast or ovarian cancer.  In fact, you may be at elevated risk, and you may not know it.

If you have questions regarding genetic testing for breast cancer, please contact me at ScuderiMD@ackermancancer.com. And, stay tuned for my next article – I’ll address factors that influence breast cancer risk, and how you can develop a stronger, personalized plan for screening surveillance.  

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