Specialists from Vail Health and Vail Health Shaw Cancer Center break down what every woman should understand about breast cancer screening, risk, treatment and survivorship and share their most important insights.

When Should You Start Screening?

Waiting until age 50 to get your first mammogram could put you at risk. Dr. Stephanie Miller, breast surgeon and medical director of breast surgery at Vail Health, underscored the consensus among breast health experts: “Starting screening mammography at age 40 and doing it yearly is going to save the most lives. We all agree about that.”

Breast cancer is one of the most common cancers among women, one in eight will develop it in their lifetime. Annual screening beginning at 40 reduces breast cancer deaths by roughly 40%, compared to 31-32% starting at 45 or screening every other year.

Understanding Your Personal Risk

Beyond Family History: A widespread misconception is that breast cancer mostly affects women with a family history. In reality, most women diagnosed have no known genetic mutation or family link. “Unfortunately, even if you don’t have a family history, you don’t have a gene mutation, we’re all at risk,” said Dr. Miller. The biggest risk factors? Being female and getting older.

The Dense Breast Discovery: Breast density is one of the least understood aspects of breast health. Dr. Kelly D’Amico, breast radiologist and medical director of breast imaging at the Sonnenalp Breast Care Center, emphasized that density is not something women can feel. “Breast density is an imaging finding,” she explained. About 40% of women over age 40 have dense breasts. Dense tissue increases cancer risk, and makes cancer harder to detect on mammograms. Women with extremely dense breasts have about twice the risk of developing breast cancer compared to those with average density. New FDA regulations now require all mammogram reports to list breast density, giving women essential information to discuss supplemental screening options.

High-Risk Screening: Some women benefit from enhanced surveillance. Katie Jones, nurse practitioner for oncology and palliative care at Shaw, uses validated risk assessment models to determine who qualifies for the High Risk Cancer Program. “We use evidence-based models to plug all those factors in and help us predict what that risk score is,” Jones said. Women identified as high-risk may start MRI screening as early as age 25 and mammography at age 30, which is earlier than average risk woman.

When Cancer Is Diagnosed: You Have More Options Than You Think

The Treatment Decision: Most women diagnosed with breast cancer have choices, including lumpectomy plus radiation or mastectomy. “The ultimate truth is that our breasts don’t control how long we live. It’s how the cancer behaves in the rest of our body,” said Dr. Miller. “Most of the time women have a choice.” Studies show both approaches offer equivalent survival, allowing women to make decisions aligned with personal values rather than fear.

Personalized Medicine Revolution: Breast cancer care today looks dramatically different from a decade ago. Tumors are now categorized by receptor status, estrogen receptor–positive, HER2-positive or triple-negative, enabling physicians to tailor treatment. “We can give more individualized care based on the specific type of breast cancer that they have,” said Dr. Miller.

The Research Advantage: Shaw Cancer Center also provides access to cutting-edge clinical trials. Paige Bordelon, who oversees research, shared that the center runs roughly 20 active trials at any given time. An impressive 30-40% of Shaw patients participate, contributing to scientific progress while gaining access to innovative therapies.

What You Can Do Today: Practical Prevention Steps

The Alcohol Question: When it comes to modifiable risk factors, alcohol stands out. “Unfortunately, a byproduct of alcohol is thought to be a carcinogen,” Dr. Miller explained. “It’s not the sugar in the alcohol, but carcinogen is a byproduct of what occurs when our body breaks down alcohol when we consume it.”

Recommended guidelines for women:

The Mediterranean Approach: No single food has been proven to prevent or cause breast cancer, but a Mediterranean-style diet, rich in vegetables, fruits, fish and olive oil, supports overall health.

Self-Breast Awareness: Formal self-exams are no longer recommended as reliable screening tools, but awareness is still important. “Everyone’s breasts are lumpy, bumpy… I just want you to feel: Is it different? Is it the same?” said Dr. Miller. Notably, most breast cancers do not present with pain. “So, the presence of a mass that does not hurt is not a reason to ignore it. People have the expectation that cancer will hurt.”

Support Systems at Shaw Cancer Center

Shaw provides a full network of resources designed specifically for mountain-town patients:

Key Takeaways: Your Breast Health Action Plan

For more information on screening, high-risk assessment or treatment options, contact Vail Health Shaw Cancer Center or speak with your primary care provider. To schedule a mammogram, call (970) 569-7690 or book online at VailHealth.org/MammoNow