Specialists from Dana-Farber/Brigham and Women’s Cancer Center, Dana-Farber Cancer Institute, and Brigham and Women’s Hospital recently introduced the Breast Cancer Personalized Risk Assessment, Education and Prevention (B-PREP) Program for patients at increased risk for breast cancer and for patients who want to better understand their risk.
“Our Program is comprised of a multidisciplinary team of breast specialists, including breast surgeons, medical oncologists, breast imagers, physician assistants and nurse practitioners as well as a social worker and patient navigator, who collaborate to deliver expert individualized evaluation and care,” says Tari A. King, MD, FACS, director of the B-PREP Program and chief of Breast Surgery at Dana-Farber/Brigham and Women’s Cancer Center.
Key services in the B-PREP Program include:
Comprehensive Risk Assessment
The B-PREP team’s risk assessment evaluates:
- Personal and family history;
- Prior findings of atypical hyperplasia (ADH/ALH) or lobular carcinoma in situ (LCIS) or other atypical lesions on breast biopsy;
- Breast density;
- Lifestyle factors including diet and exercise;
- Hormone use and other exposures contributing to breast cancer risk.
Personalized Risk-tailored Care and Education
Depending on a patient’s level of risk, the B-PREP team offers expanded testing and recommendations, such as:
- Enhanced breast imaging, with whole breast ultrasound or magnetic resonance imaging (MRI), and more frequent clinical breast exams;
- Guidelines for lifestyle changes including diet and exercise as well as direct referrals to colleagues in the Brigham and Women’s weight management program;
- Expedited access for genetic counseling and testing through the Cancer Genetics and Prevention Program at Dana-Farber/Brigham and Women’s Cancer Center;
- Options for risk reduction with proven medications as well as access to clinical trials evaluating novel medications to prevent breast cancer development and opportunities to discuss surgical risk reduction with prophylactic surgery.
With colleagues at Dana-Farber Cancer Institute, the B-PREP team is engaged in a wide range of research studies, including lifestyle interventions and clinical trials of innovative therapies to prevent breast cancer. The B-PREP team is also taking a patient-centered approach to understanding risk by engaging patients to report their own data and experiences over time in the B-PREP program.
Planned studies include:
- The use of 4-hydroxytamoxifen topical gel in women with mammographically dense breasts;
- Molecular breast imaging as a complement to Breast MR in high-risk women;
- Evaluation of novel agents in patients with BRCA germline mutations;
- Evaluation of the impact of medical weight loss reduction programs in women at high risk for breast cancer.
“By gaining a better understanding of their individual breast cancer risk, patients will be able to make more informed choices about their options and take preventative action with the support and guidance of specialists with expertise in breast cancer and breast cancer prevention,” says Dr. King.