High Risk Program

• Patients identified as high risk by MammoPlus (either here at Saint Mary's or through another program).
• Patients at high risk due to a significant family history of breast cancer.
• Patients with current non-malignant breast disease that puts them at high risk such as atypia or LCIS.
• Patients who have recently finished treatment for breast cancer - our High Risk Program offers custom surveillance for those who want a watchful eye.

Our goal is to assess your risk using state-of-the-art assessment models known as Higher Risk Application. We then develop treatment recommendations for you, which may include genetic testing, breast MRI, or preventative medication or surgery. 

We offer expertise in performing, assessing and scheduling Rapid Breast MRI. Breast MRI does not replace other breast imaging such as mammography or ultrasound, but offers additional information for certain patients with a greater lifetime risk. MRI of the breast is similar to other MRI imaging, except patients lie face down. An IV is started before the procedure, as a contrast agent is injected after a few initial images to improve the image of tissue. If areas of concern are found on the MRI, a biopsy can also be performed with MRI guidance.

What is “Risk”?

• A risk factor is anything that affects your chance of getting a disease, such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for cancers of the lung, mouth, larynx (voice box), bladder, kidney, and several other organs.


• But risk factors don't tell us everything. Having a risk factor, or even several, does not mean that you will get the disease. Most women who have one or more breast cancer risk factors never develop the disease, while many women with breast cancer have no apparent risk factors (other than being a woman and growing older). Even when a woman with risk factors develops breast cancer, it is hard to know just how much these factors may have contributed to her cancer.


• There are different kinds of risk factors. Some factors, like a person's age or race, can't be changed. Others are linked to cancer-causing factors in the environment. Still others are related personal behaviors, such as smoking, drinking, and diet. Some factors influence risk more than others, and your risk for breast cancer can change over time, due to factors such as aging or lifestyle.

• postmenopausal obesity
• use of combined estrogen and progestin menopausal hormones
• alcohol consumption
• physical inactivity
• some environmental exposures

Risk factors you cannot change

Gender

Simply being a woman is the main risk factor for developing breast cancer. Although women have many more breast cells than men, the main reason they develop more breast cancer is because their breast cells are constantly exposed to the growth-promoting effects of the female hormones estrogen and progesterone. Men can develop breast cancer, but this disease is about 100 times more common among women than men.

Aging

Your risk of developing breast cancer increases as you get older. About 1 out of 8 invasive breast cancers are found in women younger than 45, while about 2 out of 3 invasive breast cancers are found in women age 55 or older.

Genetic risk factors

About 5% to 10% of breast cancer cases are thought to be hereditary, resulting directly from gene defects (called mutations) inherited from a parent.

BRCA1 and BRCA2

The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 and BRCA2 genes. In normal cells, these genes help prevent cancer by making proteins that help keep the cells from growing abnormally. If you have inherited a mutated copy of either gene from a parent, you have a high risk of developing breast cancer during your lifetime. The risk may be as high as 80% for members of some families with BRCA mutations. These cancers tend to occur in younger women and are more often bilateral (in both breasts) than cancers in women who are not born with one of these gene mutations. Women with these inherited mutations also have an increased risk for developing other cancers, particularly ovarian cancer.

Although in the U.S., BRCA mutations are found most often in Jewish women of Ashkenazi (Eastern Europe) origin, they can occur in any racial or ethnic group.

Changes in other genes: Other gene mutations can also lead to inherited breast cancers. These gene mutations are much rarer and often do not increase the risk of breast cancer as much as the BRCA genes. They are not frequent causes of inherited breast cancer.