St. Luke’s High-Risk Breast Cancer Prevention Clinic
Peace of mind to women at an elevated risk
In America, breast cancer is the leading cause of premature death for women and ranks second as the cause of all cancer deaths. But through improvements in early detection, breast cancer deaths among women have declined by 40% since 1989. At St. Luke’s Hospital, our goal is to improve on these numbers for women in Polk County and the surrounding areas.
In 2021, St. Luke’s came online with the world-class Hologic Selenia Dimensions, a best-in-class 3D mammography platform, the only FDA-approved mammogram. A 3D mammogram combines multiple breast X-rays to create a three-dimensional breast image. We use this technology to look for breast cancer in people with no symptoms and investigate the causes of breast issues like pain, a mass, or nipple discharge.
Our new platform can take an image of the breasts in much greater detail, making it easier to see unexpected growths. As a result, 3D mammograms find up to sixty-five percent more invasive breast cancers, reduce false positives by about forty percent, and callback rates by more than fifty percent. The 3D mammogram takes several images moving in a small arc around the breast. Once the images are assembled, our radiologist looks through the breast tissue one layer at a time. With this higher level of detail, the radiologist can find cancer less than three millimeters in size. Most of these cancers cannot be seen in 2D.
KNOW YOUR GAIL SCORE
Dr. Stephenson and Savannah Hightower, AGAC-NP, have established St. Luke’s High-Risk Breast Cancer Prevention Clinic to give peace of mind to women at an elevated risk of developing breast cancer through education, increased screening options, and prophylactic treatment. Breast cancer prevention begins with healthy lifestyles. Limiting alcohol consumption and increasing physical active living is key to reducing your risk. Also essential is knowing your Gail Risk Score.
The screening mammography process identifies women at high risk for developing breast cancer. With each mammogram, we ask patients questions that help determine risk factors. This evaluation is called a Gail Model Risk Assessment." The Gail Model is one of the oldest and most well-authenticated models for predicting breast cancer risk. If you’ve had a mammogram in the last few months at St. Luke’s, your Gail Score appears in the mammogram report on MyStLukesChart.org.
The Gail Model helps to calculate a woman's risk of developing breast cancer in the next five years through a series of questions about her medical history, reproductive history, and first-degree breast cancer history. The model uses your answers to quantify your risk of developing breast cancer. If your score is below 1.67%, your five-year risk for developing breast cancer is considered low. But you are at high risk if your score is above 1.67%. Dr. Stephenson told me,
Women with a high Gail score are encouraged to participate in our high-risk breast cancer prevention program to consider risk-reduction options.
To calculate your score*, we include your:
• Age at first menstrual period
• Age at first live birth
• Number of breast biopsies
• Number of first-degree relatives with breast cancer
• Hormone usage
• Age at menopause
You can take the Gail Model Breast Cancer Risk Assessment at bcrisktool.cancer.gov
A HIGH GAIL SCORE
Through your Gail score, you've been identified as high risk for developing breast cancer and referred to our clinic by your provider. In addition to the Gail Assessment, we complete a more detailed appraisal called the Tyrer-Cuzick Risk Assessment on your first visit. With the results of this assessment, we'll discuss modifiable and nonmodifiable risk factors and ways to make changes to help decrease the risk of breast cancer based on extensive research and studies.
Dr. Stephenson is a nationally recognized medical oncologist who profoundly knows the practice of oncology and hematology. He's also very involved in cancer research at the molecular level and knows the science behind the therapy.
Your genetics, lifestyle, and environment can decrease or increase your risk. As mentioned above, regular exercise and a healthy diet can be protective factors for some types of cancer. If you're at risk for developing ductal carcinoma in situ, atypical lobular hyperplasia, or atypical ductal hyperplasia, one option that may be discussed, for example, is low-dose tamoxifen.
Dr. Stephenson is very excited about this development, saying, "Convincing evidence shows low dose tamoxifen (5mg daily for three years) can result in a significant risk reduction in developing breast cancer by as much as FIFTY PERCENT with very few side effects (if any)." This prevention and risk reduction dose is one-fourth of that used to treat actual breast cancer.
This tool is not for women who have had:
• Lobular cancer in-situ (LCIS)
• Ductal cancer in-situ (DCIS)
• A previous breast cancer
Substantiated for white women, African American women, Hispanic women, and Asian and Pacific Islander women in the United States, the calculator may underestimate risk in Hispanic women born outside the United States and black women with previous biopsies.
Many other factors can increase your risk for breast cancer.BACK