Guidelines for when to start and stop screening mammograms, as well as
how often to have them, are based on the “average patient.”
But what is the average patient? How do women know if their risk for developing
breast cancer is average or higher than normal?
The patient answers questions about her personal habits and family history
on a wireless tablet at her screening mammography appointment.
Because each person’s genetics, environment, and lifestyle are unique,
medicine is turning from traditional “one size fits all” approaches
to new strategies that take into account these unique characteristics.
It’s called precision medicine, and it’s changing the way
we improve health and treat disease.
A good example of precision medicine in action is a clinically validated
risk calculation software program used by FMH Imaging Services. Each patient
answers questions about her personal and family history on a wireless
tablet. The software then uses this data to calculate the patient’s
individual risk of developing breast cancer. The results are available
immediately, allowing the radiologist to read the report in real time.
Women found to be at high risk are notified the same day as their mammogram
and advised to follow up with their referring physician.
“The use of this breast cancer risk assessment software is just one
way that we are trying to customize healthcare to individual patients,”
said Dr. Pete Kremers, a radiologist with FMH Imaging Services.
For Women at Higher Risk
The FMH Center for Breast Care’s Screening and Prevention Program
is a resource for women who appear to have a greater likelihood of developing
breast cancer. Nurse Practitioner Patricia Rice—who is credentialed
as an Advanced Practice Nurse in Genetics through the Genetic Nursing
Credentialing Commission—reviews each patient’s family history
to determine if testing for certain genetic markers for breast cancer
(BRCA1 & BRCA2 mutations) is appropriate.
Other factors, such as age, race, breast density, alcohol and tobacco use,
and whether the patient has used hormonal replacement therapies are also
considered. Based on all the information available, an individualized
surveillance and prevention program is created for each woman, which may
include medications, nutritional counseling, and other pro-active steps
to help women at increased risk for breast cancer stay healthier longer.
A Strategy for Managing Risk
When a woman’s medical history and personal profile appear to place
her at higher risk for developing breast cancer, further evaluation through
the FMH Center for Breast Care’s Screening and Prevention program
is an option.
FMH has the technology, tools and expertise to establish the patient’s
baseline breast health profile. A genetics specialist on staff can review
factors such as the patient’s family history, age, race, breast
density and other factors. Based on these results, the patient can decide
if she wishes to be tested for breast cancer markers (BRCA1 and BRCA2).
A 3D mammogram or breast BRI may be ordered to help establish the baseline
profile. In addition, there are medications available that may reduce
a woman’s risk of developing breast cancer.
To learn more about the mammogram process, as well as the types of mammograms
Talk to your doctor if you are concerned that you may have an increased
risk for breast cancer, or call the Center for Breast Care’s Screening
and Prevention Program at 301-418-6611.