Abstract
Individuals who are at a high risk for breast cancer are a unique population. These women and men may be eligible for additional screenings for breast cancer and require education that can help reduce the risk of breast cancer. There are several risk factors, such as smoking and obesity, that can be modifiable to help reduce the risk for developing breast cancer. Currently, there are limited data on the number of high-risk programs that provide additional screening recommendations and education to patients in this population, across the country. The need to create a thorough and inclusive program that includes education for providers and patients, the latest technology in mammography, and other breast screening techniques and routine clinic visits for high-risk breast cancer patients was recognized at a cancer center in southeast Louisiana. The creation of the high-risk breast (HRB) clinic has helped ensure patients are receiving the standard of care, ensure providers are up to date on the latest guidelines, and has improved patient satisfaction across this population. The creation of this clinic has evolved over the past 3 years, including a standardization model for this population, an increase in weight loss referrals prompting interest in a weight loss clinic within the HRB clinic, and multidisciplinary monthly team meetings.
References
American Cancer Society. (2024). Key statistics for breast cancer. https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html
Bevers, T. B. (2015). Breast cancer risk reduction therapy: The low-hanging fruit. Journal of the National Comprehensive Cancer Network, 13(4), 376–378. https://doi.org/10.6004/jnccn.2015.0052
Coopey, S. B., Mazzola, E., & Buckley, J. M. (2012). The role of chemoprevention in modifying the risk of breast cancer in women with atypical breast lesions. Breast Cancer Research and Treatment, 136, 627–633. https://doi.org/10.1007/s10549-012-2318-8
Cuzick, J., Sestak, I., & Forbes, J. F. (2014). Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): An international, double-blind, randomized placebo-controlled trial. The Lancet, 383(9922), 1041–1048. https://doi.org/10.1016/S0140-6736(13)62292-8
Emons, G., Mustea, A., & Tempfer, C. (2020). Tamoxifen and endometrial cancer: A Janus-headed drug. Cancers, 12(9), 2535. https://doi.org/10.3390/cancers12092535
Fisher, B., Costantino, J. P., Wickerham, D. L., Redmond, C. K., Kavanah, M., Cronin, W. M.,…Wolmark, N. (1998). Tamoxifen for prevention of breast cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. Journal of the National Cancer Institute, 90(18), 1371–1388. https://doi.org/10.1093/jnci/90.18.1371
Freedman, A. N., Yu, B., Gail, M. H., Costantino, J. P., Graubard, B. I., Vogel, V. G., & McCaskill-Stevens, W. (2011). Benefit/risk assessment for breast cancer chemoprevention with raloxifene or tamoxifen for women age 50 years or older. Journal of Clinical Oncology, 29(17), 2327–2333. https://doi.org/10.1200/JCO.2010.33.0258
Friedenreich, C. M., Woolcott, C. G., McTiernan, A., Ballard-Barbash, R., Brant, R. F., Stanczyk, F. Z., & Courneya, K. S. (2010). Alberta physical activity and breast cancer prevention trial: Sex hormone changes in a year-long exercise intervention among postmenopausal women. Journal of Clinical Oncology, 28(9), 1458–1466. https://doi.org/10.1200/jco.2009.24.9557
Jiralerspong, S., & Goodwin, P. J. (2016). Obesity and breast cancer prognosis: Evidence, challenges, and opportunities. Journal of Clinical Oncology, 34(35), 4203–4216. https://doi.org/10.1200/JCO.2016.68.4480
Jones, M. E., Schoemaker, M. J., Wright, L. B., Ashworth, A., & Swerdlow, A. J. (2017). Smoking and risk of breast cancer in the Generations Study cohort. Breast Cancer Research, 19(1), 118. https://doi.org/10.1186/s13058-017-0908-4
King, M. C., Wieand, S., & Hale, K. (2001). Tamoxifen and breast cancer incidence among women with inherited mutations in BRCA1 and BRCA2: National Surgical Adjuvant Breast and Bowel Project (NSABP-P1) Breast Cancer Prevention Trial. JAMA, 286(18), 2251–2256. https://doi.org/10.1001/jama.286.18.2251
Mathur, P., Sathishkumar, K., Chaturvedi, M., Das, P., Sudarshan, K. L., Santhappan, S., & Roselind, F. S. (2020). Cancer statistics, 2020: Report from National Cancer Registry Programme, India. JCO Global Oncology, 6, 1063–1075. https://doi.org/10.1200/GO.20.00122
McDonald, J. A., Goyal, A., & Terry, M. B. (2013). Alcohol intake and breast cancer risk: Weighing the overall evidence. Current Breast Cancer Reports, 5(3), 208–221. https://doi.org/10.1007/s12609-013-0114-z
National Comprehensive Cancer Network. (2023). NCCN Clinical Practice Guidelines in Oncology: Breast cancer risk reduction. Version 1.2023. https://www.nccn.org/professionals/physician_gls/pdf/breast_risk.pdf
Stordal, B. (2023). Breastfeeding reduces the risk of breast cancer: A call for action in high-income countries with low rates of breastfeeding. Cancer Medicine, 12(4), 4616–4625. https://doi.org/10.1002/cam4.5288
Vogel, V. G. (2009). The NSABP Study of Tamoxifen and Raloxifene (STAR) trial. Expert Review of Anticancer Therapy, 9(1), 51–60. https://doi.org/10.1586/14737140.9.1.51
