There’s nothing quite so awful as spending a week thinking you might have cancer—and knowing that even if you don’t, one day you probably will. The chances of cancer being a genetic risk in my family is pretty high. Even though my mom’s breast cancer was BRCA1 and BRCA2 negative, the fact she and her sister both had breast cancer (their middle sister died of thyroid cancer before she was old enough to deal with the potential of breast cancer), makes me next in line. So at the suggestion of my OBGYN I did some research about what new technologies are available for women to manage the looming threat of breast cancer.

First off, the mammogram is still king. I wish it wasn’t; it is a fucking humiliating, painful, miserable experience and for people with dense breast tissue like me, it often misses small spots. The new trend in breast imaging is tomosynthesis, a form of 3D mammography that gives doctors a deeper, more thorough view of the breast tissue. It’s covered by most insurance providers and fast becoming the standard.

However, my doctor said I would need more than that. She recommended getting a breast MRI, which is the most complete internal view of the body that one can get. The problems with MRIs are twofold: 1) They are expensive (up to $1000); 2) they often find false positives. This means that they are so detailed, that they might pick up scar tissue, cysts, and other nonsense that could look like cancer.

To me, I’d rather have five needle biopsies on weird spots and have them be negative than have a mammogram miss one spot that could be deadly. If you are a low risk for breast cancer, you’ll likely never need a breast MRI, but again for people with a genetic cancer grab bag like mine, MRIs might make the difference between a little radiation and full blown chemo. Fortunately, according to my OBGYN, people like me can have what’s called a genetic risk assessment.

During the assessment, a genetic consultant will ask you questions regarding your cancer history. They consider you a potential for genetic risk if in your family you have one or more of the following: 1) a rare type of cancer, such as ovarian cancer or male breast cancer; 2) cancer at less than 50 years of age; 3) multiple primary cancers. For more information, you can visit OHSU’s Knight Cancer Institute online. If you are considered a genetic risk, some insurance companies will cover MRIs as preventative measures, which is cool.

Other preventative things young women should be doing is the time honored self exam—if nothing else to establish a baseline of what’s “normal” for your body. When I was in the shower and felt a blueberry-sized lump in my right breast, my first thought was that wasn’t there before. I know most of the lumps in my breast tissue intimately. And I know I can ignore them when they swell during my period or hormonal fluctuations. But this new one (what turned out to be the first in a large chain of benign cysts running across my breast) was cause for concern. So get in the shower, grab your favorite scented soap or massage oil, and feel yourself up!

Finally, there’s the much debated thermography. Thermography uses digital infrared thermal imaging to detect active inflammation or angiogenesis (increased blood supply as found in cancer), which MRIs and mammograms miss. Even though it was approved by the FDA in 1982, and has a track record of finding cancer up to eight years before a mammogram could detect it, radiologists and oncologists scoff at the technology as just another granola-crunching hippie “medical procedure” that will ultimately be your demise.

Personally, I’d give it a try as a way to establish a baseline for what’s normal in my body—plus it’s painless. But then again, I’m not one to scoff at natural medicine. Natural medicine has kept me from getting the flu or a legitimate cold for several years. For more information on thermography, check out Oregon Natural Medicine for an appointment or to talk to someone about whether it’s right for you.

At the end of the day, cancer can come out of nowhere. It’s just a cell, like all our other cells, replicating the same as our healthy cells, only it’s evil. There are lots of ways to fight it, and lots of ways to try preventing it—but it’s up to us to lead responsible, healthy lives. No one is going to love your breasts as much as you—I mean look at them! They deserve it.