High-Risk Hereditary Cancer Program
Our comprehensive breast care services at Cape Cod Healthcare include a specialized program to identify and monitor patients at high-risk for developing breast cancer and other types of cancer.
Patients who meet certain criteria for breast cancer risk will receive more intensive screening and may be recommended for additional medical management, such as preventive medicine or surgery.
How do I know if I’m considered a “high-risk” patient?
Cape Cod Healthcare offers patients several ways to review family and personal medical history to determine risk for breast and other cancers:
- Every patient receives a comprehensive hereditary cancer risk assessment at an appointment for a routine screening mammogram or diagnostic testing.
- This assessment can also be completed via our online hereditary cancer risk survey.
- Our Nurse Practitioner specializing in Genetics is available for a consultation appointment (a PCP or OB/GYN referral may be necessary).
Knowing the risk factors for breast cancer
Familial risk factors for breast cancer include:
- Family and personal history of breast, ovarian, and other cancers
- Age of first period
- Age of first child (or if no children)
- Age of menopause
- Breast changes and previous breast biopsy
- Estrogen exposure - hormone replacement therapy, oral contraceptives
- Breast density
- Prior radiation therapy
- Lifestyle factors such as smoking, alcohol, etc.
Hereditary breast cancer risk due to genetic mutations include:
- Three or more blood relatives with breast cancer
- Two blood relatives with breast cancer, one under the age of 50
- Ovarian cancer present in you or a blood relative of any age
- Male breast cancer present in you or blood relative of any age
- Known hereditary mutation in a blood relative
- Personal history of breast cancer under the age of 50 or ovarian cancer at any age
- Triple negative breast cancer under the age of 60
- Ashkenazi Jewish ancestry with a personal history or blood relative with breast or ovarian cancer
Based on this assessment, patients may receive further education and counseling about genetic testing for a variety of genetic mutations that can cause breast and other cancers, which is offered through a simple blood test or saliva sample. Although most breast cancers are sporadic in nature, approximately 10-15% are caused by a genetic mutation. If a person inherits one of these mutations, the lifetime risk of developing breast cancer can be increased by up to 80% and that of developing ovarian cancer can be increased by up to 40%.
If there is an absence of hereditary cancer risk, it is still possible for a patient to have high familial risk based on the above factors such as personal and family medical history, age, hormone exposure, and lifestyle behaviors. High familial risk is defined as greater than 20% lifetime risk of developing cancer based on risk calculations. Your PCP or OB/GYN can help you in reviewing your individual risk factors, and refer you to our Nurse Practitioner specializing in Genetics for an in-depth assessment.
A patient with a confirmed genetic mutation for breast or ovarian cancer or high familial risk will automatically be enrolled in our High-Risk Hereditary Cancer Program.
If I’m enrolled, what should I expect?
All patients considered high-risk for breast cancer will receive the benefits of more intensive monitoring by our team of skilled breast care experts. High-risk patients receive:
- A clinical breast exam every 6-12 months
- Annual screening 3D mammogram
- Annual screening breast MRI
- Individualized risk reduction, such as referral to medical oncology for risk reduction medication, referral to breast and plastic surgery for preventive breast surgery
- Genetic counseling and option to pursue testing, if not done previously
- Personalized treatment and follow-up
If you or your family members are concerned about the risk of breast cancer, we are here to help guide you through the evaluation process. For more information please call Cuda Women’s Health Center (508) 957-1700.