Download High-risk Breast Cancer Screening Program

Strategies for Reducing Breast Cancer Risk
Our team can help reduce a woman’s risk of developing
breast cancer. Our specialists suggest specific strategies to
consider for reducing chances of developing the disease.
Remember, being at high risk for breast cancer does not
necessarily mean you will get breast cancer.
Lifestyle Changes
There are several lifestyle changes that can help women
reduce their risk of developing breast cancer. These include
exercise and maintaining a normal weight, reducing
alcohol consumption, and possibly eating a low-fat, highfiber diet rich in fruit, vegetables and whole grains.
Avoiding prolonged exposure to artificial light may also
help reduce risk.
Opportunities to Participate
in Research Studies
As research studies become available, women at high risk
have the opportunity to join in studies to help understand,
identify and decrease breast cancer risk. Researchers at the
UMass Memorial Cancer Center are committed to bringing
results from the laboratory into the clinical setting as
quickly as possible.
High-risk Breast
Cancer Screening
Breast cancer affects more women than any other type of
cancer, with the exception of skin cancer. Each year, almost
200,000 women in the United States learn they have
breast cancer. While the exact causes are not known, we
do know that factors such as family history, age and race
influence the occurrence of breast cancer.
The High-risk Breast Cancer Screening Program, a part of
the Comprehensive Breast Center at UMass Memorial
Medical Center, offers the region’s only specialized
program to help identify and monitor women at high risk
for developing breast cancer. Early identification of risk
allows women and their health care providers to work
together to create an appropriate screening regimen for
breast cancer detection.
Women and their family members concerned about breast
cancer can receive an evaluation by a team of breast cancer
specialists. Our team offers:
• Personalized risk assessment
• Clinical breast exam
• Screening tests
• Genetic counseling and education about breast cancer
risk
Support Services
At times, women may feel overwhelmed regarding their
increased risk of breast cancer or other life issues. Support
services including social and psychological counseling are
available through referral from the High-risk Program. The
specially trained staff identifies ways to cope with concerns
and make the best decisions about reducing risk and
treatment.
High-risk Breast
Cancer Screening
Program
• Preventative agents (e.g., Tamoxifen and Raloxifene)
About Our Centers of Excellence — The Cancer, Diabetes, Heart
and Vascular, and Orthopedics Centers of Excellence deliver
seamless programs of quality and compassionate care for patients
across our health care system. Developed to meet the needs of our
community, our centers offer an experienced team approach to
specialized treatment, advanced therapies and breakthrough clinical
trials. Our highly trained physicians and staff provide patientcentered care in modern facilities with the latest technologies as we
educate tomorrow’s health care leaders and advance science
through research at the University of Massachusetts Medical
School.
The only specialized program in
Central Massachusetts to help identify
and monitor women at high risk
UMassMemorial
Health Care
UMass Memorial Health Care is the largest not-for-profit health
care system in Central New England with more than 13,000
employees and nearly 2,000 physicians, many of whom are
members of UMass Memorial Medical Group. Our member
hospitals and entities include Clinton Hospital, HealthAlliance
Hospital, Marlborough Hospital, UMass Memorial Medical Center,
Wing Memorial Hospital and Medical Centers and Community
Healthlink, our behavioral health agency. With our teaching and
research partner, the University of Massachusetts Medical School,
our extensive primary care network and our Cancer, Diabetes,
Heart and Vascular, and Musculoskeletal Centers of Excellence we
deliver seamless programs of quality and compassionate care for
patients across our health care system.
• Clinical prevention trials
• Treatment plan and follow up
Women may be referred to the High-risk Program by their
primary care physician or obstetrician/gynecologist. For
more information, please call 508-334-6200.
Follow umassmemorial on:
High-risk Breast Cancer Screening Program
UMass Memorial Medical Center – University Campus
55 Lake Avenue North, Worcester, MA 01655
Tel: 508-334-6200
www.umassmemorial.org
UMassMemorial
Health Care
0213 MRKG
Risk Factors for Breast Cancer — Who Is at Risk?
All women are at risk for developing breast cancer.
However, there are certain factors that may increase the
chance of getting the disease. These include:
• Age – The number one risk factor for developing breast
cancer is age. Risk increases as a woman ages. Three
out of four breast cancers occur in women over age 50
and the risk is highest for women over age 60.
• Race – Breast cancer occurs more often in Caucasian
women than African American, Asian or Hispanic
women.
age. About five to 10 percent of women with breast cancer
have a hereditary form of the disease. Some individuals of
Ashkenazi (Eastern European) Jewish decent have been
found to have an inherited characteristic that may increase
their risk of developing breast or ovarian cancer.
• Certain breast changes – Women with a non-cancerous
condition in which cells have abnormal features and are
increased in number or abnormal cells found in the lobules
of the breast) or having had two or more breast biopsies
for other benign conditions are at increased risk.
• Personal history of breast cancer – Women who had
breast cancer face an increased risk of developing it in
the other breast.
• Childbearing – Women who had their first child after age
30 and women who have had no children have a greater
risk.
• Family history of cancer – A woman is at greater risk if
her mother, sister or daughter had breast cancer,
particularly before menopause. Also, risk is higher if two
or more other close relatives, such as aunts or cousins,
have a history of breast cancer, especially at a young
• Estrogen – An increased length of exposure to estrogen,
including the pill, influences risk. This includes women who
began menstrual periods at an early age, entered
menopause at a late age, or who take hormone
replacement therapy for an extended period of time.
Screening for Breast Cancer
Women faced with the possibility of being diagnosed
with breast cancer are concerned for their own health as
well as their sisters and daughters. Screening does not
decrease women’s chances of developing breast cancer,
but it clearly increases the chance for early detection and
successful treatment. Screening for cancer includes breast
examination or other testing for early stage disease, even
though they have no symptoms. Breast cancer screening
may include the following:
• Mammogram – A screening mammogram is the best
tool available for early breast cancer detection. The test
can often identify cancer before symptoms appear. A
mammogram can also reveal calcium deposits in the
breast, which although benign, may be an early sign of
cancer. Women at increased risk for the disease should
• Breast density – Cancer is more likely to occur in
breasts with dense tissue than in breasts with fatty
tissue. Also, dense, glandular breasts make identifying
abnormalities on a mammogram more difficult.
• Radiation therapy – Women whose breasts were
exposed to radiation therapy before age 30, especially
those treated with radiation for Hodgkin’s disease, are
at increased risk.
• Lifestyle factors – Some studies suggest that certain
lifestyle behaviors can put women at greater risk for
developing breast cancer. These include excessive
alcohol consumption; lack of exercise and weight gain,
particularly in postmenopausal women; and working at
night under artificial lighting.
Most women who develop breast cancer have none of
the risk factors listed above, other than the risk that
comes with growing older.
Assessment for Women at High Risk
have an annual mammogram beginning at an age that
is five to 10 years younger than the youngest member
of the family with breast cancer.
There are several methods available to assess breast
cancer risk for women with a family history of breast
cancer or other factors that increase their likelihood of
developing the disease. Once women are identified as
high risk, one or more of the following assessments may
be made to determine the appropriate personalized plan
for breast cancer prevention and monitoring.
• CASH model – This model relies on data from women
who had breast cancer and who have first- or seconddegree relatives with breast cancer (e.g., mother, sister,
aunt). Unlike the Gail model, it incorporates a woman’s
age at diagnosis and paternal relatives with a history of
the disease. The risk for the unaffected relative can
then be calculated based on her age.
• Self breast exam – This test may be helpful in
identifying breast abnormalities and should be
performed monthly, about one week after the end of
menstruation.
• Gail model – This assessment tool, developed by the
• Genetic counseling and testing – Although most
breast cancers occur in women who do not have a
• Breast MRI – Extremely dense breast tissue may
make mammograms difficult to interpret. Certain
women with this or other conditions may benefit from
the use of breast MRI.
breast cancer over a five-year period and over her
lifetime. The calculated score can then be used as a
guide for establishing personalized breast cancer
prevention and monitoring programs.
• Clinical breast exam – This is a thorough physical
examination of the breasts done by a physician or nurse
practitioner. This exam is recommended every six to
12 months for women at high risk.
National Cancer Institute and the National Surgical
Adjuvant Breast and Bowel Project, enables a health
professional to estimate a woman’s individual risk for
strong family history of the disease, about five to 10
percent have a genetic predisposition for breast cancer.
Women with a BRCA gene mutation have up to an 80
percent lifetime risk of developing breast cancer, and a
15 to 45 percent risk of ovarian cancer.