Breast cancer is one of the most commonly diagnosed cancers in women in the U.S. and is the second leading cause of cancer death in American women.
“One in eight women will develop breast cancer in their lifetime,” says Lindsey Jonker, women’s health nurse practitioner at Holland Hospital’s Women's Specialty Care.
This month, the U.S. Preventative Task Force changed their guidelines to align with the American Cancer Society and the American College of Gynecologists (ACOG). The updated guidelines recommend that women at average risk start screening for breast cancer at age 40. But for some women, an annual mammogram is not enough.
The Holland Hospital High Risk Breast Clinic helps identify women who are at an increased risk for breast cancer and works with them to either reduce their risk or diagnose breast cancer in its earliest stages when it is most treatable.
“Our goal is prevention,” says Jonker. “If we can prevent or detect breast cancer early, we can improve survival rates.”
Holland Hospital High Risk Breast Clinic
Most patients are referred to the High Risk Breast Clinic through Holland Hospital Women’s Specialty Care, their primary care provider or a specialist. If a screening mammogram shows a patient may have a higher risk of developing breast cancer, providers will recommend a formal breast cancer risk assessment with the clinic.
To calculate a patient’s lifetime risk of developing breast cancer, the clinic primarily uses what is known as the Tyrer-Cuzick risk model, which accounts for personal history (age at first period, age at menopause, BMI, hormone replacement therapy (HRT) use and breast biopsies) as well as for factors such as family history, genetic test results and breast density. The risk model pools all this information and calculates a risk score.
A patient with a greater than 20% lifetime risk of developing breast cancer is considered high-risk and qualifies for additional screenings. Providers help the patient create a risk-reduction plan that includes lifestyle changes like aerobic exercise, limited alcohol consumption, weight management, healthy diet along with risk-reduction medications if necessary. They also recommend an annual mammogram as well as an annual breast MRI so they are being screened twice a year.
For patients with a family history of certain cancers, the clinic uses a program called Progeny to see if they would qualify for genetic testing. If they are found to have a hereditary gene mutation that puts them at an elevated risk for breast or ovarian cancer, the clinic then discusses appropriate preventive or risk-reducing surgeries.
The importance of breast self-awareness
Jonker recommends that all women practice breast self-awareness to catch breast cancer early and while it is the most treatable. “Women should know what their breasts feel and look like,” she says. She recommends looking for a hard, fixed lump and skin changes like dimpling, puckering or scaling, or nipple discharge. If any of these changes occur, contact your doctor immediately for further evaluation.
Holland Hospital Breast Care Fund
Holland Hospital has established the Holland Hospital Breast Care Fund for women who are uninsured, underinsured or who have high deductibles to ensure all women have access to mammograms and diagnostic services. The fund helps remove financial barriers that might deter women from this lifesaving screening through private donations and grants. Learn more or see if you qualify here.
Where can I learn more?
The Holland Hospital High Risk Breast Clinic is designed to calculate a woman’s lifetime risk of developing breast cancer, provide genetic testing (if appropriate), tailor an individualized prevention plan and recommend an appropriate screening and follow-up schedule. For an appointment, call (616) 355-3815.