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Christina Applegate's Breast Cancer: FAQ

Applegate's Breast Cancer Found Early; Full Recovery Expected, Says Actress' Publicist

continued...

There's a couple of other issues that come up. No. 1, do you need to consider genetic testing? Because if you're having breast cancer in the 30s, again, it's relatively uncommon and you start thinking about do they have a family history, could they possibly have the breast cancer gene? So that would also impact how you would follow them.

The other issue is do you get breast MRIs, and that's extremely controversial.

Routine follow-up for women with breast cancer, even young women -- we'll presume they do not have the gene -- is physical exams every six months and routine mammography, and that's all.

Routine mammography being once a year?

Yes. You might do it a little bit more frequently for the first time or so but then after a year or so, no, then just back to once a year. There's no value in doing more frequent mammography than that.

Are breast cancers more aggressive in young women?

As a group, if you took 100 young women vs. 100 65-year-olds, yes. But what I always tell patients is it doesn't really matter what the whole group is; it matters what your particular tumor is. You will have more aggressive tumors in young women and fewer in older women. But the individual characteristics are really what's important to that patient.

Applegate's mother had breast cancer and cervical cancer. How does family history affect her risk?

Clearly because of the fact that her mom had breast cancer, you now have two people in the family with breast cancer. There's no family history of ovarian [cancer]?

The report I saw said breast and cervical cancer but not ovarian cancer.

Cervical [cancer is] not related. But her risk of having the breast cancer gene is now up to 6%, 7% and there are different ways to calculate that. And now she's only 36 years old, her mom had breast cancer -- I'll presume it was postmenopausal -- so I'm at least having a conversation with her about genetic testing [if I were her doctor].

Applegate's breast cancer was found through MRI. It's not clear from her publicist's statement if this was her first, baseline MRI or if she's gotten other MRIs to screen for breast cancer. In March 2007, an expert panel convened by the American Cancer Society recommended that only women at high risk of breast cancer get annual MRI screening in addition to mammography. Where do you stand on MRI screening?

It depends what month you ask me. It is a very, very controversial topic. We are using the recommendations that you just alluded to. But there is no data -- the women who are getting routine MRI -- and I use that term in italics because I'm not sure exactly what that means, is that every year or every other year? -- are people who have the BRCA1 or BRCA2 [breast cancer] gene, which is why I think for somebody like her, it would be very important to do. Other than that, women who are at very high risk -- and very high risk in our practice means a Gail risk of 20% or higher.

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