Early Screening and Risk Assessment Is Not Just for Superstars
In this week’s People magazine, the cover story is about Olivia Munn (who has starred in Date Night, X-Men: Apocalypse,The Newsroom and other movies)and her journey through breast cancer. But the story doesn’t start here, as Olivia mentions in the article.
Olivia talks about having a normal mammogram and normal genetic testing. However, her doctor decided to calculate her risk score and found that it was 37%. This prompted the recommendation of a breast MRI. The MRI is what found Olivia’s breast cancer. Now she has come out in several publications encouraging every woman to know her risk score.
We at The Breast Center have thought that every woman knowing her risk score is very important for quite some time. We began our high-risk clinic in 2015 but obtained the software in 2021 for the most comprehensive risk assessment, the Tyrer-Cuzick risk calculator. Since then, every woman that comes through our center has her risk score assessed.
Screening recommendations are then made based on the patient’s risk score. For example, women that are >20% and less than 40 years old would start their screening MRI at age 25 and screening mammogram at age 30. Women who are 40 and over, would have their mammogram every year and a supplemental MRI would be recommended if their risk score is >20%. We also offer women with an intermediate risk score of 15-20% a supplemental MRI (this is a discussion with their provider) since many of them have a first degree relative that has had breast cancer but do not have other risk factors that put their risk >20%.
Olivia’s case is not an isolated case. We have diagnosed many patients with breast cancer from the MRI that had a normal mammogram 6 months earlier. This is because MRI is the most sensitive test when it comes to breast imaging. I’m sure that brings up the question, why not give everyone a breast MRI? Mammography is still the standard of care in breast imaging and sees things such as microcalcifications that no other screening modality shows. Also doing MRIs on every woman would be cost prohibitive and there would not be enough MRI magnets to keep up with the demand. So, the best way to have the MRI available to the most appropriate patients is by assessing their risk score.
We are thankful that Olivia has used her experience to help educate woman about knowing their risk score. This is something that we at The Breast Center have been passionate about for quite some time. Always remember that knowledge is power, and that knowledge empowers you to make the best possible decisions about your health.