Ask Dr. Ulissey | March Q/A

  • Thursday, March 15, 2018 3:01pm
  • Life

Q: I have high risk factors for developing breast cancer (27 percent) so I asked my doctor about Breast MRI. I was told that since I tested negative for the BRCA1 and BRCA2 genes, I don’t need it.

A: Unfortunately, the literature does not support that notion, so I must disagree with your doctor. There are many factors that go into determining a woman’s risk for developing breast cancer, and genetic composition is just one of them. The percentage of breast cancer that is genetically related is actually pretty low. In fact, The CDC estimates that only 5 to 10 percent of breast cancers are from genetic mutations, which means that more than 90 percent of women who develop it, will also test negative for genetic markers like BRCA1 or 2.

Many other factors go into the validated high-risk calculation models. They include, but are not limited to, things like family history, age when starting first menstrual period, age of starting menopause, having dense breast tissue, not being physically active, radiation therapy for medical conditions before the age of 30, and several other factors. Take a look at this basic list from the Centers for Disease Control.

The American Cancer Society guidelines for obtaining breast MRI in high risk women include women who test positive for BRCA1 or 2 genes, but also women who are above 20 percent lifetime risk as calculated by one of the standard models (like Tyrer Cuzick or BRCAPRO), even if they are BRCA negative. A more complete list is posted on its website: cancer.org.

In summary, even though you are BRCA negative, your risk factors are above 20 percent, so I think most specialists in the field would recommend a breast MRI for adjunct surveillance, even if your mammogram is normal, and especially if you have dense breast tissue.

Michael J. Ulissey, M.D., is a partner at the Breast Diagnostic Centers of Auburn and Federal Way. In addition to taking care of patients locally, he continues to participate in research as an adjunct professor at the University of Texas Health Sciences Center. You can reach him at michael.ulissey@cdirad.com.

More in Life

Wedding & Event Show comes to Green River College March 2

The eighth annual Wedding & Event Show comes to Green River College… Continue reading

New exhibit on view in Auburn

Museum displays Microcosms: The Photography of George L. Kinkade, open through April 28

Feb. 23 event features more than 200 tables of glass, jewelry and collectibles

The 42nd annual Green River Glass Show and Sale returns to the… Continue reading

Michael Lim, concertmaster of the Pacific Northwest Ballet Orchestra, makes his Auburn Symphony debut Sunday. COURTESY PHOTO, Michael Lim
ASO presents Brahms Sibelius, a romantic symphony concert, this Valentine’s Day seekend

The Auburn Symphony Orchestra performs Brahms & Sibelius, a special Valentine’s Day… Continue reading

Scale model show takes mini to the max

NorthWest Scale Modelers exhibition to display hundreds of models at Museum of Flight

Auburn community calendar | Feb. 15

Events Auburn Tourism: For special events or to add a special event,… Continue reading

Auburn-area community calendar | February

Events, entertainment and other listings

For whodunit lovers, this short story is a gleefully-dark delight

Growing older is a very good thing. First of all, there’s a… Continue reading

Search no more, you’ll want to read ‘Hero Dogs’

You felt like such a loser. It was a feeling that didn’t… Continue reading

Destination Moon: The Apollo 11 Mission exhibition

Tickets on sale for Museum of Flight’s major exhibition that celebrates the first lunar landing 50 years ago

You’ll want to hang tight when reading ‘The New Iberia Blues’

Your hand is deep in a bucket of crunchy goodness. Without popcorn,… Continue reading