However, the risk of breast cancer development for an average woman is less than 1 in 25 during a 10 year time frame, and experts now have identifiable risk factors and instruments that can identify women who are truly at moderately high or very high risk for cancer.
With this knowledge, the University of Cincinnati (UC) Cancer Institute’s Breast Cancer Center has opened a Risk Assessment and Management Program to evaluate whether a patient is at high risk for the development of breast and ovarian cancers.
“The goals of the high risk program are to promote awareness of levels of breast and ovarian cancer risk to patients, families and health care providers and to provide an expert evaluation for the management of high risk patients,” says Elyse Lower, MD, director of the center, professor at the UC College of Medicine and a UC Health oncologist. “Based on individual risk assessment, patients will be offered appropriate counseling, testing and primary prevention measures to reduce the likelihood of cancer development.”
The clinic will be held Monday mornings on the third floor of the UC Health Barrett Cancer Center, 234 Goodman St. Patients who have been identified as possible high risk for cancer development can self-refer or be referred from physicians within UC Health or the greater Cincinnati region.
“Our multispecialty UC Health physician team includes Thomas Herzog, MD, gynecologic oncologist, Elizabeth Shaughnessy, MD, and Jaime Lewis, MD, both surgical oncologists, Larry Sobel, MD, breast imaging, and myself, an oncologist,” adds Lower. “Following the initial evaluation by our nurse practitioners, Diana Sutherland from medical oncology and Sadie Supinger from surgical oncology, along with genetic counseling from Cincinnati Children’s Jennifer Hopper, patients will receive a personalized care plan evaluating risk and the next steps. They will also receive individual navigation to ensure that appropriate tests and follow up are offered.”
Those who are eligible for the high risk clinic include people with:
Strong family history of breast (male or female) and/or ovarian cancer.
Known personal or family genetic abnormality in a breast cancer-causing gene, like BRCA, CHEK-2 or Palb B2.
Prior breast biopsy showing atypical results.
Gail Model breast cancer risk of greater than or equal to 1.67 percent over the next five years or greater than 20 percent lifetime risk.
History of chest wall radiation to treat Hodgkin’s disease.
Dense breasts on imaging.
“Physicians will evaluate treatment based on criteria met by the individual, providing information needed to make decisions on risk reduction based on one’s wishes,” Lower says.
Risk-reduction strategies could include genetic testing, increased surveillance—diagnostic mammograms and breast MRIs—prophylactic surgeries, like preventive mastectomies or hysterectomies, or chemoprevention.
“A high risk clinic like ours can provide data which can foster research collaboration within the institution, region and other academic centers, as well,” says Lower. “This multidisciplinary approach to women’s cancer risk assessment and management will involve our dedicated breast imaging team and genetics experts along with gynecologic oncology, surgical oncology and medical oncology. Comprehensive assessment and management is an unmet need in our region, and we’re so happy to provide this tool for individuals at risk.”
To schedule an appointment or find out more, call 513-584-RISK.