They’re the questions that come into our minds after midnight, when we’re trying to go to sleep. The ones that cause us to wonder—and worry. The ones that we’re afraid our doctors will think are silly.


But if we, or someone we love, are at risk for breast cancer, there are no silly questions.


About 120 out of every 100,000 women in Georgia and South Carolina will be diagnosed with breast cancer in her lifetime, according to the Centers for Disease Control and Prevention, making breast cancer the most commonly diagnosed cancer among women in the two states, and second only to lung cancer in deaths. October, which is Breast Cancer Awareness Month, is not only a time to celebrate breast cancer survival, but to learn about your own risk and get the facts about breast cancer.


Here are a few frequently asked questions:


1. If I find a lump in my breast, do I have cancer?


Most breast lumps are not cancerous. But any lumps or other changes in the breast should be reported to your physician. A breast exam and tests such as mammograms can determine whether the lump is something to worry about.


2. Can mammograms give me breast cancer, or cause cancer to spread?


This is a very common myth. Mammograms use very small amounts of radiation, and risk of harm from exposure is very low. For years, mammograms have been used safely as the gold standard in screening for breast cancer.


The National Cancer Institute recommends mammograms for women age 40 and older every one to two years. Talk to your physician if you have a family history of the disease or other risk factors, which might indicate an earlier start or increased frequency.


3. What is my risk for breast cancer?


The National Cancer Institute, as well as the GHSU Cancer Center and others, uses a tool that looks at age, medical history, family history of breast cancer and race/ethnicity to help determine a general personal risk of breast cancer.


However, many factors determine a risk for breast cancer, and women should work closely with their health care professionals to discuss results from these or similar tools.


4. If my sister had breast cancer, will I get breast cancer, too?


Only about 10 percent of breast cancers overall are related to family history.


But family history can be a predictor of breast cancer, especially if first-degree relatives (sister, mother or daughter) had breast cancer and if the cancer occurred when they were younger than 50. If your grandmother or aunt had breast cancer, your risk increases as well, but only slightly.


If you do have a family history, tell your doctor. He might suggest genetic testing to see if you carry BRCA1 or BRCA2 breast cancer gene mutations. Genetic testing should take place only upon the advice of a doctor and only if a genetic counselor is available to discuss your results with you.


5. If I have the BRCA1 or BRCA2 gene mutations, will I definitely develop breast cancer?


These mutations multiply the risk of developing breast cancer by five, but they don’t guarantee it. Talk with your physician about your risk as well as preventive treatments, such as the drug Tamoxifen, which reduces risk by 50 percent or more. Another preventive option includes removal of the breasts, and women of childbearing age may choose increased surveillance, including more frequent clinical exams and mammograms.


Have more questions? Talk to your doctor, or call the GHSU cancer hotline, staffed weekdays from 9 a.m. to 5 p.m., at 888-365-0747. And remember, while talking about cancer can seem scary, increased knowledge can only improve your health.


Dr. Samir N. Khleif is Director of the Georgia Health Sciences University Cancer Center.