High risk breast cancer program

The Allina Health high risk breast cancer program surrounds you with a health care team who will help you create a plan to manage your unique breast cancer risk. This team may include your primary care provider, a genetic counselor, a registered nurse, medical oncologist and other breast specialists. The program includes: 

• a complete assessment of your breast cancer risk 

• frequent, regular breast screenings 

• genetic counseling

• interventions to reduce your risk—these may include lifestyle changes, medicines or surgery 

Your personal and family history are the greatest contributors to your breast cancer risk. Here are some of the factors that will put you at higher risk.  

Personal history. You are at greater risk if your individual health history includes: 

• a breast biopsy showing LCIS (lobular cancer in situ) 

• a breast biopsy showing ADH (atypical ductal hyperplasia) or ALH (atypical lobular hyperplasia) 

• a history of radiation therapy to the chest between the ages of 10 and 30 

• BRCA1 or BRCA2, CHEK2, TP53, PTEN or other known breast cancer gene mutation 

Family history. About one in 10 breast cancers is hereditary. This means the cancer is caused by certain genes that run in families. You are at greater risk if you have: 

• a close relative with breast cancer at a young age, usually younger than 45-50 

• a close relative with ovarian cancer 

• two or more close relatives with breast cancer on the same side of the family, especially if diagnosed at an age younger than 60 

• a brother or father with breast cancer 

• a family member with BRCA1 or BRCA2, CHEK2, TP53, PTEN or other known breast cancer gene mutation. 

Whatever your personal or family history, your health care team will work with you to evaluate your risk. 

Finding breast cancer early is crucial—especially for those who are at high risk. At Allina Health, we provide the best-available tools and technologies for detecting breast cancer. These include: 

• 2D Mammography. A low-dose digital X-ray of your breast. 

• 3-D mammography (tomosynthesis). Where a standard mammogram takes flat images, a 3-D mammogram takes many images from several angles, which are combined by a computer to produce a three-dimensional image of your breast.  

• Breast ultrasound (sonography). This technology uses sound waves to “see” the inside of your body. A computer monitor shows the images from the sound waves. These images can provide information to help diagnose and treat cancer. 

• MRI (magnetic resonance imaging). An MRI uses a magnetic field and radio waves to make three-dimensional (3-D) images of your breasts on a computer. It is often done after a diagnosis to assess the size of tumors and see if any cancer cells have spread. 

The American Cancer Society guidelines recommend that women who identified as a high risk for breast cancer should consider a breast MRI and a mammogram every year. Your team of experts in the high-risk program will help develop a screening program based on your risk and your needs. 

Along with frequent screening, some people at high risk may decide to take other steps to reduce their breast cancer risk. Your health care team will present you with risk-reducing treatment options based on your unique situation. Your nurse navigator, genetic counselor, medical oncologist, surgeon and other members of your team will make sure that you understand each treatment option and that you are prepared for the options you choose. Risk-reducing options include: 

• Lifestyle changes. This may include changes to your diet, smoking habits, alcohol consumption, exercise and other parts of your daily life.  

• Risk-lowering medicines. Medicines such as tamoxifen or raloxifene lower your risk of breast cancer by blocking or reducing hormones in your body that help cancer grow.  

• Prophylactic mastectomy. This is a preventative surgery where one or both breasts are removed to lower your risk of developing breast cancer.  

• Prophylactic oophorectomy. In this surgery, the ovaries are removed to prevent them from producing hormones that can contribute to breast cancer.  

Whether you have private health insurance, Medicare or Medicaid, the coverage and benefits differ from plan to plan and provider to provider. It is important for you to understand your health care benefits before your screenings or treatments. Check with your insurance provider and find out exactly what is and is not covered under your plan, and how much you have to pay yourself.