Ignoring your family history with cancer isn't worth the risk. Penn State Health Breast Center team can help you decrease your risk for developing breast or ovarian cancer.

It is important to keep in mind that true hereditary cancer is rare. In hereditary breast and ovarian cancer syndrome (HBOCS), a "mutation" or change, in a single gene can be passed from either parent to a child. This inherited mutation can greatly increase a person's chance of developing breast, ovarian or other cancers.

Learning about your risk early may help you prevent cancer from occurring. It can also help you detect it early, when it is most treatable. Many women have found that understanding their inherited risk of developing breast or ovarian cancer provides a better opportunity - and additional options - to protect their health and the health of women in their family.

Penn State Health Breast Center offers genetic consultation to help you understand your risk for HBOCOS. If appropriate, genetic testing may be considered to determine if you have a gene alteration. Our team provides support every step of the way, from an initial consult to reviewing results and discussing your options.

Our team of specialists meets with individuals to obtain a personal and family medical history. You will learn the significance of risk factors and the role genetics play in your cancer risk.

Then, you will be provided a detailed plan of care tailored to your specific risk level. Personal plans may include a schedule of periodic mammograms, physical exams, breast MRI, prophylactic surgery or preventative anti-hormone therapy. Tamoxifen and exemestane have been shown to decrease breast cancer incidence in women at higher-than-average risk of breast cancer.

Cancer risk assessment and genetic counseling require confidential and personalized care by a team of specialists. Counseling sessions provide more information about your risk for breast and ovarian cancer.

Our cancer risk assessment includes:

• A detailed family history evaluation
• Personal risk assessment for breast and ovarian cancer
• Genetic testing discussion (if needed) including risks, benefits and limitations
• Complete review of personal screening and surveillance guidelines

Full written report from the patient's counseling sessions

Screening mammograms are low dose X-ray exams of the breast. They are most often used to screen for breast cancer in women who have no symptoms. 

Diagnostic mammograms are for women who have breast symptoms, such as a lump or pain, or who have a change on their screening mammogram. The diagnostic exam can include additional views. Often sonography is used in conjunction with the diagnostic mammogram to better evaluate and area of concern.

3D mammography, also called tomosynthesis or digital breast tomosynthesis, is a state-of-the-art imaging technique that creates individual images of the breast tissue. This provides a clearer picture, helping identify areas in the breast that may not be visible on 2D images alone.

Pennsylvania law requires that annual mammograms must be available at no cost to consumers, regardless of whether it is 2-D or 3-D.  Out-of-state and private insurers may choose to not follow these guidelines.  It is important to check with your carrier before your appointment.

Women should have a yearly mammogram starting at age 40. The American Cancer Society’s guidelines state that starting annual mammograms at 40 can save the most lives. Many other professional medical organizations follow this recommendation, including the American College of Radiology (ACR) and the Society of Breast Imaging (SBI).

Learn more about breast screening guidelines.

The entire appointment will take about 20-30 minutes. You will undress from the waist up. Your breasts will be in compression for a few seconds at a time to get each image. When performed appropriately, the mammogram should not be painful. If your breasts are more tender during certain times of your cycle, consider scheduling your mammogram when your breasts are not as tender.

Schedule your screening mammogram today. Call our 24-hour hotline at 800-243-1455. We offer Saturday and evening appointments for added convenience.

Learn more about mammography screening.

When the breast tissue on mammogram is dense (more white on mammogram), the mammogram may not be as sensitive for the detection of small masses compared to a woman with more fatty breasts (less white on mammogram). There is some data that suggests that the risk of breast cancer is higher if your breast tissue is very dense. You will be informed of your particular pattern of density when you receive your result letter. In some patients with dense breast tissue, supplementary screening tools may be appropriate. These are performed in addition to the mammogram, not in place of the mammogram and can include whole breast ultrasound or MRI breast screening exams.

Mammograms are not the only screening tool available for breast cancer. Some women may need additional tests, such as an automated whole breast ultrasound. This test may be recommended if you have dense breasts or a higher-than-average risk of developing breast cancer. 

Your appointment for the ultrasound will take about 45 minutes. You will need to undress from the waist up and lie down on the exam table. Lotion will be applied to your breast. Then, a scanner will be used to take images of breast tissue. 

Learn more about automated whole breast ultrasound.

There are often no symptoms of breast cancer. Women may feel a lump or notice unusual changes to their breasts. However, breast cancer is most commonly found only after a screening mammogram. If your physician notices an abnormality on your mammogram, you will need additional diagnostic testing. That may include:

• Breast ultrasound
• Breast biopsy

A breast ultrasound uses high-frequency sound waves to provide images of your breast tissue. It can provide more detailed information about an abnormality seen on mammogram and can help to further define an area that you can feel in your breast. 

Breast ultrasounds do not use radiation. You will need to undress from the waist up and lie on an exam table. Gel will be applied to the area with the lump. Your physician will use a small wand to scan the area and exam the lump. This entire procedure takes about 30 minutes.

Learn more about breast ultrasounds.

A breast MRI uses a specialized coil and provides pictures based on the magnetic resonance of different tissues. It is often used to examine patients who have been recently diagnosed with breast cancer and can help determine if there are any additional sites of tumor in the breast. It is also a valuable screening tool for women at high risk for breast cancer.

The breast MRI is a relatively comfortable and easy exam. You will be asked to arrive a half an hour early to fill out paperwork and change into a gown. You will need an IV for a contrast agent called gadolinium. The gadolinium helps to determine normal from abnormal breast structures.

Then, you will be asked to lie on your stomach on a cushioned bed. Your breasts will be positioned within a padded cutout on the bed. This bed will move into the magnet for the exam. You will be provided with ear protection as the machine makes loud knocking sounds while it obtains the images. With ear protection you will hear a muffled knocking sound that lasts for several minutes. During the scan, you can listen to music of your choice. The exam requires that you lay on your stomach; the best images are obtained when you can lie very still.  While the imaging portion of the exam is less than 30 minutes, you can expect to be in the radiology department for about one to one and a half hours.

Learn more about magnetic resonance imaging.

A core biopsy uses a needle to acquire small amounts of tissue from a mass (lump) or an area of calcifications. Your radiologist will recommend a biopsy if your diagnostic study (mammogram, ultrasound or MRI) shows an area that could be cancer.

During your biopsy, a local numbing agent will be used. We will use imaging, such as an ultrasound, mammogram or MRI, to identify the suspicious area in your breast. Then, we’ll insert a needle into the skin and collect core samples through the needle. Next, we’ll place a small marker into the breast to mark the biopsy site.

This procedure takes about five to 15 minutes, depending on the type of biopsy you have. However, you can expect to be at your appointment for 45-60 minutes.