Most Breast Cancer Patients Lack Family History, Experts Urge Broader Risk Assessment
Professor Tannir Alois, head of the Breast Unit at Hadassah Medical Center, explains that the common belief linking breast cancer primarily to family history is misleading. Over 80% of women diagnosed with breast cancer have no significant family history, especially among first-degree relatives such as mothers, sisters, or daughters. While family history remains an important risk factor, particularly when multiple relatives are affected or cancers occur at a young age, its absence does not guarantee low risk.
Breast cancer is the most common malignancy among women in Israel and worldwide, affecting about 12.5% of women during their lifetime. The risk increases with age and is rare before 40, but younger diagnoses are more often associated with hereditary factors. Notably, family history from the paternal side is equally significant in risk assessment. Genetic mutations, especially in BRCA1 and BRCA2 genes, contribute to 5% to 10% of cases. Israeli health policy recommends genetic screening for women of Ashkenazi or Ethiopian descent starting at age 25, as these populations have common mutations.
A recent British study highlighted that relying solely on family history for risk evaluation misses up to 95% of younger women at high risk or who develop breast cancer. The study advocates for more comprehensive risk models incorporating lifestyle, reproductive history, and genetic data. Professor Alois supports personalized risk assessments starting in the early 30s and tailored screening protocols, including mammography and additional imaging like ultrasound or MRI for high-risk women.
Additional risk factors include obesity, alcohol consumption, and lack of physical activity, though many breast cancer cases occur without identifiable risk factors beyond gender and age. Early detection remains crucial, with mammography proven to reduce mortality. Women are urged to monitor for any breast changes such as lumps, skin alterations, or nipple discharge and seek prompt medical evaluation.
Hadassah Medical Center plans to pilot an AI-based risk assessment tool, Mirai, which analyzes mammograms to predict breast cancer risk up to five years ahead. This innovation aims to enhance early detection and personalized prevention strategies. Professor Alois emphasizes that despite uncertainties in breast cancer causes, early diagnosis and advanced treatments have significantly improved survival rates.
