Ascension Medical Group High Risk Breast Program
Some women are at a very high risk for developing breast cancer in their lifetime. Ascension Medical Group's High Risk Breast Program was developed for women of all ages who want to understand their risk of breast cancer and to determine if they have options to reduce that risk. The intent of this clinic is to offer women a program that consists of early detection, surveillance and access to education and clinical trials.
Accessing the High Risk Clinic:
The most efficient way to access the clinic is by referral from a primary care physician or gynecologist. You may also contact us directly, but please remember that some insurance companies require a referral to reimburse visits to specialists.
Once your referral is received, you will be contacted by the nurse navigator who will provide information and explain the process. You will be asked to complete a very detailed history form as well as a complete family history. If you are a candidate for the high risk clinic an appointment will be made for you for a prevention consultation. If you are not a candidate for the high risk clinic, you are still welcome to be seen in our breast center to discuss your options.
Topics Included in the Prevention Consultation
- Utilization of the Gail Model and other models that project your five-year and lifetime risk of developing breast cancer. This risk assessment requires a very detailed personal and family history.
- Breast imaging recommendations including digital mammography with CAD assistance, sonography and MRI (if applicable). The appropriate imaging techniques can help diagnose a cancer at an earlier stage.
- Breast exam by a breast surgeon.
- Minimally invasive (very small incisions) biopsy techniques if a biopsy is recommended.
- BRCA genetic testing. If you have many women in your family who have developed breast cancer (especially at a young age), you may want to consider this testing. BRCA1 and BRCA2 are the names of the first two genes to be discovered that increase risk of breast and ovarian cancer. Only about five to 10 percent of breast and ovarian cancers are strongly related to mutations in these genes. Most women who develop breast and ovarian cancer do not have these genes, but a small number will inherit these mutations and a blood test is available to determine if the gene is present.
- Lifestyle changes that may help decrease your risk such as decreasing fat in your diet.
- Chemoprevention is a technique which uses a medication (tamoxifen or raloxifene) to decrease the risk of developing breast cancer. The Breast Cancer Prevention Trial found that tamoxifen reduced the risk of developing breast cancer in high risk women.
- Discussion of prophylactic (preventative) breast surgery for women who are at very high risk, especially those who have the BRCA genes. Reconstructive options from board certified plastic surgeons are available for women who choose this option.
- Clinical trials will be discussed. These are research studies that offer the most cutting edge preventative options available.
- Supportive care including information and emotional support as well as ongoing monitoring and recommendations.
- Close contact with your other physicians to make sure they are aware of your screening, test results and recommendations.
Am I at risk?
All women are at risk for getting breast cancer as they get older and should be screened, however, certain women have a much higher risk than the general population due to some additional risk factors. These women may need to be screened and followed more carefully.
Breast cancer risk factors:
- Women who have their first menses before age 12 have a one to two times higher risk
- Women who have their first child (or no children) after age 30 have a 1.4 times higher risk
- Women with a first degree relative with breast cancer have a two to three times higher risk (and this risk increases with more affected first degree relatives)
- Women with a personal history of breast cancer have a four times higher risk
- Women with pre-malignant changes on a previous biopsy (LCIS or atypia) have a four to five times higher risk
- Women who have a combination of family history and cellular atypical have an up to ten times higher risk