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At 34, I was nervous about my breast cancer risk. Here's what I did

Sony Salzman is a health and medical reporter for ABC News.

October 30, 2024, 4:13 AM

As a health and medical reporter, I've covered a steady drumbeat of headlines about the alarming uptick in breast cancer cases among adults in their 20s, 30s and 40s. I've read the studies. I've spoken to concerned doctors, distraught patients.

Even still, it took me a long time to face the fact that I myself was at an increased risk for breast cancer.

By 34, I was already overdue for a conversation with my doctor about screening.

My mom was diagnosed with breast cancer in her late 40s. Thankfully, she has been in remission now for more than a decade, but her yearslong battle is still a hauntingly fresh memory.

After doing some research, I enrolled in a program for younger adult breast cancer screening at Memorial Sloan Kettering in New York. After an initial consultation, I was scheduled for a mammogram and genetic screening.

I felt relieved -- I had finally taken action to be proactive about my cancer risk.

ABC News' Sony Salzman is pictured on the day of her first-ever mammogram.
Sony Salzman/ABC News

But on the day of my mammogram, I spotted a woman in the waiting room sporting a hospital gown and a bald head. She looked young. And she looked sick.

Suddenly, I was scared.

The truth is, getting screened isn't hard just because of the complex logistics of scheduling appointments, filling out paperwork, and the prospect of battling insurance to cover early screenings.

It's also hard because it means looking at the possibility of cancer square in the face.

Thankfully, my scan was clean. The experience was positive and empowering. The mammogram itself was uncomfortable, but not painful.

I learned I have dense breast tissue, which means I may need supplemental imaging, like MRI and ultrasound, to detect potential cancers early.

When I posted about my mammogram experience on Instagram, I was flooded with a remarkable number of comments from friends just like me: scared of the headlines, but unsure where to start.

"Can you tell me everything?" one friend wrote. "I've had low grade panic about it since Olivia Munn got diagnosed but haven't done anything about it."

ABC News' Sony Salzman is pictured on the day of her first-ever mammogram.
Sony Salzman/ABC News

Beyond high-profile celebrity diagnoses, recent data paint a grim trend. Rates of breast cancer climbed 1% per year from 2012 to 2021, and even more sharply for women under 50, according to a recent report from the American Cancer Society.

The sharpest increase was seen in women in their 20s, whose rates increased by 2.2% per year.

This rise in younger-onset cancers is one reason a major federal task force recently lowered the age of average screening from 50 to 40 years old. But that's just a guideline for women with "average risk."

Many women have higher-than-average risk, and may need to start screening in their 30s, or even 20s.

Doctors aren't sure yet exactly why breast cancer cases are increasing in younger adults, whether it's ultra processed food, environmental toxins, lifestyle factors or a combination of many of these factors.

But studies show that about 40% of cancers are potentially preventable depending on the actions we take -- eating well, quitting smoking, staying active and scheduling your screenings when it's time, according to the American Cancer Society.

As part of ABC News' ongoing coverage for Breast Cancer Awareness Month, it felt important for me to step outside my normal role as a reporter. I want to remind people that anyone -- including a health and medical reporter -- can easily feel overwhelmed by the process of starting breast cancer screenings.

Now, on the other side of my first mammogram and with a strong plan moving forward, I feel hopeful.

5 steps for women to take

Based on my personal experience and tips from the CDC, here are five steps you can take today if you are worried about your breast cancer risk.

1. Call your family members and ask about any and all cancer history. This might be hard -- people don't like to talk about cancer. But a diagnosis among your blood relatives directly influences your risk. It could mean the difference between insurance deciding to cover preventative screening, or not.

2. Armed with this information, ask your primary care doctor or gynecologist for a breast cancer risk assessment. The time to start thinking about this is when you are in your 20s. Some medical groups recommend that certain women with higher risk get a risk assessment by age 25.

3. If you know you are high-risk, find a program that specializes in early cancer detection. Many major cancer centers have them. You can also talk to your primary care doctor to get a referral. And there are federal programs for low-income or under-insured Americans to get screened early too.

4. If you have had a mammogram in the past and you know you have dense breast tissue, ask your doctor about supplemental imaging. Dense breast tissue makes it harder to spot cancer using a mammogram. If you've had a mammogram but you aren't sure whether or not you have dense breast tissue, ask your doctor.

5. Know your own breasts. You may not need a mammogram or other medical tests before the age of 40. But you should never discount a new symptom, even if you are young. Tell your doctor right away if you notice any lumps, skin changes, nipple changes or changes in the shape or size of your breasts.

Sony Salzman is a health and medical reporter in the ABC News Medical Unit.