High risk for breast cancer calls for increased screening at CCRI clinic

High risk for breast cancer calls for increased screening at CCRI clinic

For Fershurn Stanford, Barbara Herring is a lifeline.

Stanford is a patient at the high-risk breast cancer clinic of the Cancer Center and Research Institute at the University of Mississippi Medical Center.

"She keeps me focused, and I'm grateful for that," said Stanford, of Canton. "I have breast cancer in my family, but you can tell yourself that you'll get around to getting screened, and then five years go by. She called me in, and I'm now on schedule for breast cancer screening."

Designed for patients with a 20% or higher lifetime risk of breast cancer through family history, genetic mutations that may increase a person's risk of breast cancer such as BRCA1 or BRCA2, or a previously diagnosed benign but high-risk lesion, the clinic inside the UMMC Medical Pavilion provides advanced screening and information aimed at detecting breast cancer early, said Herring, the clinic's nurse practitioner. Supplemental screening with breast MRI may also be useful for women with dense breast tissue.

"Our goal is to give high-risk patients the tools and education they need to stay ahead of breast cancer," she said. "Our clinic offers advanced screening and clear information so women can understand their risk and detect cancer as early as possible."

The average woman has 12.9% lifetime risk of breast cancer, meaning about one in eight women will fight breast cancer in her lifetime, according to the National Cancer Institute, which offers a breast cancer risk assessment calculator online.

Following American Cancer Society screening recommendations for those at high risk for breast cancer, clinic patients stop in twice a year, once for an MRI and once for a mammogram starting at 30. Each of those visits also includes a clinical breast examination.

"The combination of MRI and mammography along with a clinical breast exam gives us a fuller picture of overall breast health and are essential tools to assist us in finding breast cancer earlier when treatment is most effective," Herring said.

Women who have a parent, grandparent or sibling who has had breast cancer or know that they have a genetic mutation that makes breast cancer more likely can request an appointment to discuss their individual risk for breast cancer by calling 601-815-6700.

Knowing whether cancer is in the family can help in understanding your own risk and making informed decisions about screening and prevention, said Dr. Barbara Craft, professor of medicine in UMMC's Division of Hematology and Oncology.

"It is important for a person to know their family history as it relates to breast or other types of cancer," she said. "The earlier cancer is found, the more likely it is that we can treat and possibly cure patients of their disease. At UMMC, we also have certified genetic counselors available to meet with patients, offer genetic testing and help guide them through other cancer screenings they may need."

The clinic is essential for the health of women who are at high risk for developing breast cancer, said Dr. Wade Christopher, associate professor of surgery and a specialist in the surgical treatment of breast cancer.

"High-risk breast cancer screening with alternating MRI and mammograms every six months is critical in high-risk patients," Christopher said. "Breast cancer is treatable if detected early, and we have advanced imaging tools available to identify any suspicious areas at an early stage. We recommend all patients discuss their individual risk of breast cancer with their primary care doctor and seek high-risk breast cancer counseling and screening if they are found to have a lifetime risk greater than 20%."

A patient's first visit to the clinic starts with a conversation, Herring said. "We talk about personal and family history including whether they have had genetic testing or want to have genetic testing done. One of the advantages of care at UMMC is that we have experts in genetic testing who can guide patients through what their results mean and help them understand the next steps in managing their risk."

A personal breast cancer risk assessment is essential, Herring said, noting that the absence of a genetic mutation doesn't eliminate the possibility of elevated risk.

In addition to a family history of breast cancer and the BRCA1 and BRCA2 gene mutations, reasons for a higher risk of breast cancer can include:

• Radiation therapy to the chest during childhood or adolescence.
• Li-Fraumeni syndrome, Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome or have first-degree relatives with one of these syndromes.
• Having extremely dense breast tissue.
• A benign breast lesion that is considered high-risk such as atypical ductal hyperplasia, atypical lobular hyperplasia or lobular carcinoma in situ (LCIS).

Call the UMMC Cancer Center and Research Institute at 601-815-6700 for a personalized breast cancer risk assessment.