The High Risk Breast Cancer Program is designed to take care of patients who have no symptoms but are at high risk for breast cancer.
The term high risk as it applies to breast cancer means that the individual is at an increased risk compared to the general population. 1 in 8 women get breast cancer nationally and this number 1 in 8 is considered average risk. If a person’s risk is higher than 1 in 8 they are considered high risk.
- Women who have first degree relatives such as a mom, sister, daughter, father, son with breast cancer are considered at high risk.
- Women with family history of any male breast cancer.
- Women with more than two second degree relatives with breast cancer.
- Women with personal history of ovarian cancer.
- Women with family history of pancreatic cancer, ovarian cancer, and uterine cancer.
- Women who have the Breast Cancer Gene/BRCA positive are at high risk for future breast cancer.
- Women who have a family member (male or female) with BRCA gene mutation.
- Women who had breast cancer in one breast in the past are at high risk for future breast cancer in the same breast and or the opposite breast.
- Women with abnormal cells or atypia on breast biopsy are at high risk.
- Women who had previous radiation to chest wall for other cancers are considered high risk for future breast cancer.
- Certain Ethnic Backgrounds.
The other factors that can increase a woman’s risk are the usage of hormone replacement therapy, dense breast tissue, and DES exposure in utero and others.
Genetic Testing and Counseling
A woman’s risk of developing future breast and or ovarian cancer is significantly increased if she inherits the BRCA 1 gene or the BRCA 2 gene.
About 12 percent of women will develop breast cancer in the general population. Women who have the harmful BRCA 1 and or BRCA 2 gene can have a risk up to 87% chance of developing future breast cancer by 70 years of age. Women who have the harmful BRCA1 and or BRCA 2 gene can also have up to 44% chance of developing future ovarian cancer.
Men with the BRCA 1 and or BRCA 2 gene mutations also have an increased risk of developing future breast cancer, prostate cancer.
Who should consider genetic testing for BRCA 1 and or BRCA 2 mutations?
- Women who are diagnosed with breast cancer under the age of 45.
- Women who are diagnosed with breast cancer under the age of 50 with family history of breast cancer.
- Women diagnosed with two breast cancers at the same time.
- Women diagnosed with triple negative breast cancer under the age of 60.
- Personal and or Family history of Male breast cancer.
- Personal history of epithelial ovarian cancer.
- Family history of breast cancer, ovarian cancer, pancreatic cancer in multiple relatives.
- Ethnic groups including Ashkenazi Jewish, Hungarian, Swedish, Icelandic descents.
Genetic Counseling is recommended before and after any test for an inherited cancer syndrome by the National Cancer Institute. Genetic Counseling can be performed by a health care professional who is experienced and versed in cancer genetics, it can be your Physician. Dr. Niru Anne’s training at Roswell Park Cancer Institute in Cancer Surgery/Surgical Oncology constituted of cancer genetics didactics, genetic counseling, and interpretation of the test results to tailor the clinical care of her patients. Depending upon the results of the Genetic test and the patient’s risk assessment, the patients are appropriately followed in the High Risk Breast Program. If deemed appropriate, the family members are offered Genetic Testing and Counseling as well.
Patients who are carriers of the BRCA 1 and or BRCA 2 gene are offered Nipple Sparing Mastectomies for risk reduction purposes if deemed appropriate.
High Risk Breast Program
The goal of the high risk breast program is to provide risk reduction for these women who are at higher risk of developing breast cancer than the average population. The goal really is to reduce the risk and if possible prevent cancer. Men who have the above risk factors are at future risk of breast cancer as well.
Our Breast Surgeon, Niru Anne, MD, FACS, sees patients and evaluates their risk based on family history, personal history, and risk factors. Dr. Anne discusses the role of Bilateral Breast MRI depending upon the percentage risk of developing future breast cancer. Dr. Anne also offers genetic counseling and testing for patients who qualify for it based on the NCCN guideline. A referral is made to medical oncology if necessary to discuss chemo-prevention to lower the patient’s risk through medications (such as tamoxifen) as per the national guidelines. A High risk breast program was an integral part of Dr. Anne’s training at Roswell Park Cancer Institute, where she did Specialty Training in Cancer Surgery/Surgical Oncology. Prevention, when possible, is the goal of the High Risk Breast Cancer Program.
Women who are at substantial risk for the development of future breast cancer are offered risk reduction with prophylactic surgery if appropriate with Nipple Sparing Mastectomy Procedure and enrolled in the National Nipple Sparing Mastectomy Registry Program.
At the Women’s Health Center, we are still accepting new patients into Dr. Anne’s high risk breast program.
A referral from your primary care provider is not necessary. If you feel you are at high risk based on the above risk factors, you may call our office at 607-798-5916. Our office staff can assist you with the necessary insurance approvals. You may also qualify for financial assistance.