Just over 12 percent of American women — one-in-eight — will be diagnosed with breast cancer in her lifetime. But because of family history or an inherited genetic mutation, some women are at a much higher risk than others for getting breast cancer.
The UCLA High Risk Breast Clinic in Santa Monica provides eligible women, referred by a primary care physician or other specialist, access to a multidisciplinary team that includes a medical oncologist, genetic counselor, clinical nutritionist and breast surgeon. The team designs a personalized screening and risk-reduction strategy, with the goal of preventing breast cancer or detecting cancer as early as possible so that it can be aggressively treated.
“Breast cancer is a highly curable cancer,” says Aashini Master, DO, the center’s lead physician. “But that’s only true if we catch it before it has spread and reached a metastatic stage.”
Most women who are seen at the center either have the BRCA1 or BRCA2 gene mutation, which brings one’s lifetime risk for developing breast cancer up to 70-to-80 percent; are of Ashkenazi Jewish descent with a family history of breast cancer; or have a first- or second-degree relative — meaning a mother, sister, aunt or grandmother — who was diagnosed with breast cancer before they turned 50. “The younger a family member was at the time of diagnosis,” Dr. Master says, “the more it’s going to impact a patient’s risk.”
Women with a lifetime risk greater than 20 percent are considered to be at high risk and are eligible to enroll in the program. While most of the program’s patients are in their 30s or 40s, Dr. Master has some patients in their 20s.
After age 30, high-risk women often start receiving regular mammograms. This is significant, because an average-risk woman doesn’t typically get her first mammogram until sometime between 40 and 50 years old — which may be too late if she has any significant family history, Dr. Master says.
In addition to more rigorous screening, Dr. Master and her team work with high-risk women to put them on an anticancer nutrition program, and they discuss other lifestyle changes, such as limiting alcohol intake to three glasses per week and exercising three hours a week. They also review complementary therapies and other preventive steps, such as going on an anticancer medication like tamoxifen if they have a high five-year risk or having a surgery to remove the breasts before cancer forms, known as a prophylactic mastectomy.
“Many of the patients we see already are anxious about their risk of developing breast cancer and are worried they’re not receiving the correct screenings based on their risk,” Dr. Master says. “Having a program like this captures this population in which we can detect the cancer at a much earlier stage than what would be possible with a typical screening protocol, and it really can make a difference.”