Community Healthcare System opens High-Risk Breast Clinic
(From left to right) Dr. Mary Nicholson, Medical Director, Dr. Janice Zunich, Medical Geneticist, Suzanne Ruiz, R.N., M.S., NP-C and Dr. Rajshri Shah, Breast Radiologist of the High-Risk Breast Clinic.
Women living with the fear of breast cancer may find peace of mind after visiting the new High-Risk Breast Clinic in Munster. The High-Risk Breast Clinic of the Women’s Diagnostic Center is staffed by experts in the field who provide individualized recommendations for prevention and surveillance to those at increased risk.
Women at elevated risk for breast cancer can come into the Clinic, with their physician’s order, and receive an individualized assessment. There they will find other important services including a clinical breast exam by a certified nurse practitioner, education about breast self-exams, screening tests, education about breast cancer risk, a personalized surveillance plan, and prevention strategies. The Clinic staff is on hand to help coordinate scheduling and pre-authorization of imaging studies. They are also ready to provide referrals to valuable resources and supplemental support, such as genetic or psychological counseling; nutrition experts; and research studies.
“Our primary goal is to assist women in learning ways to cope with their concerns about developing cancer, and help them make the best decisions about reducing their risk,” said Mary Nicholson, M.D., medical director of the Clinic who also serves as regional director of breast imaging services for Community Healthcare System.
Factors that can increase a women’s risk of developing breast cancer include her age (four out of five breast cancers diagnosed are in women over 50); family history (mother, daughter, sister had breast cancer, particularly before menopause or a father/brother with breast cancer); an Ashkenazi Jewish family lineage; certain breast changes (diagnosis of atypical hyperplasia or lobular carcinoma in situ); menstrual period beginning at an early age; going through menopause at a late age; having no children, or having your first pregnancy after age 30.
Screening tests that are used to detect early-stage disease in those who show no symptoms include clinical breast exam and digital mammography. For women with an elevated lifetime risk of breast cancer, annual screening breast MRI, in addition to an annual mammogram is recommended by the American Cancer Society. The Women’s Diagnostic Centers of Community Healthcare System, known for innovative breast care, provide results of screening mammograms within the same visit, and same-day results for non-surgical biopsies.
At-risk women do have options to reduce their risk for breast cancer. These options, which may be explored at the High-Risk Breast Clinic, include:
• Surveillance - Monthly breast examination and an annual breast exam by a primary-care provider is encouraged for all women. A yearly mammogram is recommended for women age 40 and older and an annual breast MRI is an added recommendation for those at high risk. Regular exercise, smoking cessation, maintaining a healthy weight and limiting alcohol are also key prevention strategies.
• Drug therapy - Two drugs, Tamoxifen and Raloxifene, have been proven to reduce the risk of breast cancer in women at high risk.
• Surgical therapy — This is the most life-changing approach women may take to reduce breast cancer risk.
Although most breast cancers occur in women who do not have a strong family history, about 10 percent are traced back to a genetic predisposition for the disease. Patients with a significant family history (mother, father, brother or sister) of breast cancer have a risk of carrying a specific genetic mutation, and may benefit from a more specific method of estimating breast cancer probability, called BRCAnalysis, available at the Clinic through our medical geneticist.
“Genetic testing may help some women learn whether or not they have an increased likelihood of developing breast cancer or whether inherited factors have contributed to their own or a family member’s cancer,” said Janice Zunich, M.D., medical geneticist on staff at the High-Risk Breast Clinic.
You may want to consider a visit to the High Risk Clinic if you:
• Have a lifetime risk of breast cancer of 20 percent or greater using standard risk assessment models
• Have a BRCA 1 or 2 mutation
• Have a first-degree relative with a BRCA 1 or 2 mutation
• Received radiation treatment to the chest between ages 10 and 30
• Carry or have a first-degree relative with genetic mutation in the TP53 or PTEN genes
The High-Risk Breast Clinic is located at the Women’s Diagnostic Center, 10020 Donald Powers Drive, in Munster. A physician order is necessary for referral. For more information, call 219-934-8869.