Adding the family history increases her risk by about three-fold, which increases her risk to 3 in 50. Therefore, her risk goes from 2 percent to about 6 percent when her family history risk factor is added. The woman should definitely get a mammogram if it has been more than a year since her last exam or if she feels a new lump or thickening. During her study, we would examine that area very carefully by taking some extra views and perhaps doing an ultrasound. We now know that breast cancer, while less common in this age group, tends to grow a bit faster than in older women.
Breast cancer can be very hard to see on a mammogram.
I once had a patient whose mammogram looked fine. As she was leaving, she told us about a lump she had felt for a couple of years in her right breast. She had brought in her old mammograms, and I took some additional views. Then the ultrasound showed a small, very slowly growing cancer. She was treated and is now doing fine.