By Alexandria W. Diego, DNP, APRN, AOCNP, Certified GCRA Specialist, Certified Breast APP
Women who are at an increased risk for breast cancer benefit from high-risk breast surveillance and assessment. Women who may be at an increased lifetime risk of developing breast cancer include those with a close family history of breast or ovarian cancer, a genetic predisposition based on an inherited gene mutation (ex. BRCA 1/2 mutations), dense breasts, previous breast biopsies resulting in abnormal or atypical cells and/or prior chest radiation therapy between 10-30 years of age.
A woman at high risk for breast cancer is noted to have a Tyrer-Cuzick lifetime risk calculation of 20% or greater. In these cases, high risk surveillance could be indicated which includes clinical breast exams (CBE) every six months and mammograms once a year, as well as annual breast MRIs with intravenous contrast. Breast imaging is usually started at age 40, unless a patient’s doctor requests the patient begin at an earlier age.
Patients at high risk for breast cancer are also educated regarding breast awareness for new breast symptoms or issues and lifestyle changes such as exercise, smoking cessation, moderation of alcohol consumption, weight management, prophylactic breast surgery and risk-reducing medications. It is imperative that the medical community understand the importance of screening women for breast cancer, and referring women who are at an increased risk for specialized breast evaluation.
Currently at Holy Cross Health, within the Surgical Oncology department, there is an established high risk breast clinic that is open for appointments. Women who are determined to be at an increased risk for breast cancer in the high-risk breast clinic will have a risk assessment completed as well as counseling and education regarding recommendations and interventions at the initial and subsequent visits. Genetic screening and testing are offered to women who meet criteria according to the National Comprehensive Cancer Network (NCCN). Patients who are determined to have an increased risk for breast cancer related to a genetic predisposition are also followed for high-risk surveillance and may also be evaluated by a breast surgeon in the office to discuss surgical risk-reducing options.
At another one of Holy Cross Health’s facilities, the Dorothy Mangurian Comprehensive Women’s Center, the Partners in Breast Health program provides outreach education, clinical breast exams, screening mammograms and diagnostic procedures to lower income and minority women ages 40 and older who lack access to healthcare services. The program also provides services to symptomatic women who are younger than 40.
Committed to providing patients with quality care, The Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Health maintains accreditation from the National Accreditation Program for Breast Centers (NAPBC), a quality program administered by the American College of Surgeons (ACS). The Center can be reached at (954) 542-6700.
Alexandria W. Diego is nurse practitioner at Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Health.
