Some women may have a high risk of breast cancer due to familial and genetic
factors, abnormal mammogram findings and more. The High Risk Breast Clinic
provides breast cancer screening, genetic testing for risk evaluation,
and chemo-prevention for individuals at increased risk of breast cancer.
Our multidisciplinary team includes a specialty-trained genetics nurse
practitioner who will work with you to provide education, hereditary cancer
risk assessment, genetic counseling and testing, individualized cancer
screening and prevention programs to people who are concerned about their
personal and family history of breast cancer.
A visit to the High Risk Breast Clinic may be right for you if you meet
the following risk factors.
RISK FACTORS
Family History and Genetic Factors
If you have a personal or family history of any of the following risk factors
you will benefit from a referral to the High Risk Breast Clinic to discuss
hereditary breast cancer risks:
Family history of a known mutation for a cancer predisposition syndrome
(e.g. BRCA1 or BRCA2)
Breast cancer diagnosed at 45 years or younger
Breast cancer diagnosed at any age, AND one or more of the following:
Personal history or family history of ovarian cancer
Family history of breast cancer diagnosed at or before 50 years of age
Family history of two or more relatives diagnosed with breast cancer at any age.
Triple negative breast cancer diagnosed before 60 years of age
Family history of male breast cancer, pancreatic cancer, metastatic prostate
cancer or high grade prostate cancer (Gleason > or = 7)
Personal or family history of follicular thyroid cancer, endometrial cancer,
and/or dermatological manifestations of Cowden syndrome
Personal or family history of sarcoma, adrenocortical cancer or brain tumors
Ashkenazi Jewish ancestry
Unknown or limited family history
Men with a personal history of breast cancer
Bilateral cancer (or two breast primaries) diagnosed at any age
High Risk from Risk Assessment Models
Every woman undergoing her annual mammogram at the Breast Imaging Center
at Valley View, will be screened with the Tyrer-Cuzick questionnaire (AKA
IBIS tool). It is used to calculate a person’s likelihood of carrying the
BRCA1 or
BRCA2 mutations. It estimates the likelihood of a woman developing breast cancer
in 10 years and over the course of her lifetime. The tool is used to help
inform a person’s decision-making about genetic counseling and testing.
The tool estimates breast cancer risk on the basis of the following risk factors:
Age
Body mass index
Age at menarche
Obstetric history
Age at menopause (if applicable)
History of a benign breast condition that increases breast cancer risk
(hyperplasia, atypical hyperplasia, LCIS)
History of ovarian cancer
Use of hormone replacement therapy
Family history (including breast and ovarian cancer, Ashkenazi inheritance,
genetic testing if done)
You and your doctor will use results from your breast cancer risk assessment
to determine if you have an increased risk of breast cancer. If the model
predicts a 5% or greater chance that the woman has a mutation in BRCA1,
BRCA2, or both, genetic counseling is advised. If the model predicts a
20% or greater lifetime risk of developing breast cancer you may be referred
by your primary care to the high risk breast clinic for additional assessment
and development of an individualized plan for ongoing screening and surveillance
for breast cancer.
Biopsy Proven Pre-malignancy
Some patients are eligible for a visit to the High Risk Breast Clinic due
to a previous breast biopsy with any of the following findings:
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