Becoming Experts in Detecting Breast Cancer
With nearly 300,000 newly diagnosed cases of breast cancer in the US each year,1 those at risk rely on women’s imaging centers and high risk breast centers to help detect cancer at the earliest and most treatable stage. Establishing a high-risk breast care program can help identify families at the greatest risk for developing cancer, and screen them more frequently so that aggressive cancers are caught in time.2
Women with hereditary cancer mutations carry different risk profiles than women with family history risk alone. The US Preventive Services Task Force recommends that women at risk for BRCA1 and BRCA2 pathogenic mutations receive genetic counseling and, if indicated after counseling, genetic testing.3 A woman’s risk for breast cancer may be increased from ~12% risk to >60% risk if a hereditary cancer mutation is identified.4,5
Natera offers NateraCore support services that help integrate the EmpowerTM Hereditary Cancer Test into your center’s breast cancer screening programs. As screening hubs, high-risk breast clinics are uniquely positioned to help connect patients with these life saving services, often to mutual benefit—patients get more tailored care while imaging centers gain better patient relationships and repeat visits.
Improving Patient Care
Care Plans Tailored to Risk
Patients at high risk of developing breast cancer have many options available to them to help mitigate risk, such as more frequent and more advanced imaging screening (such as breast MRI), prophylactic or risk-reducing surgery (such as mastectomy), breast cancer medications (such as tamoxifen), and reproductive support to help reduce the chances of passing on hereditary cancer to their children.4-6 By identifying risk levels, you can help your patients make informed decisions about proactive measures to protect their health.
Better Access to Advanced Screening & Preventative Treatments
Once identified, high-risk patients typically qualify for coverage for screening and preventative services, reducing a common barrier to advanced imaging. While genetic status is an important component of risk, measures like Tyrer-Cuzick can help women who do not have genetic variants associated with cancer understand their risk based on factors such as family history and estrogen exposure. Empower results include a Tyrer-Cuzick score for patients who do not have genetic variants associated with breast cancer risk. Results from genetic testing or Tyrer-Cuzick can help your high-risk patients receive increased coverage and support.7
Increased Insight After Diagnosis
An estimated 85% of women who have or have had breast or ovarian cancer have not been offered hereditary cancer testing.8 Knowing a patient’s genetic status can help guide treatment decisions and predict their risk of recurrence. All patients who have had a breast cancer diagnosis should be offered a risk assessment and the option for hereditary cancer testing if they have not received it previously. Many high-risk breast clinics now offer survivorship programs to help patients who received breast cancer treatment in the past return for updated risk assessments to help understand recurrence risk.
Protecting Families
Hereditary cancers run in families. Patients who discover a high risk genetic status through hereditary cancer testing have the opportunity to inform their family members of the potential that they might also have a genetic predisposition to cancer. This information can help connect families with testing services and preventative care.
Growing Your Center’s Business
Stand Out From Other Centers
Building a reputation for high quality care in your community helps your high-risk breast clinic gain recognition from other clinicians and local organizations, increasing your referral base. Building a high risk program that includes risk assessment and hereditary cancer testing can help bolster your center’s capabilities and community standing.9
Demonstrating improved patient outcomes is one of the best ways to grow your center’s reputation. With the streamlined data collection that digital solutions offer, high-risk breast clinics can analyze data, show improved outcomes, and set goals for program improvements. Natera makes it simple to efficiently add hereditary cancer testing to an existing breast screening program and track patient outcomes.
Offering genetic testing may also help improve patient satisfaction and likelihood to return. A recently published peer-reviewed survey, which sought to better understand genetic testing use and decision making among high-risk women, found that among those who underwent genetic testing, nearly all were very satisfied with their decision to be tested.10
Educate Patients About Hereditary Cancer Risk
Many women may over or underestimate their risk of breast cancer based on personal and family history.11,12 As part of creating a high risk breast care program, imaging centers can provide education and help to increase awareness of what it means to be at high risk for breast cancer and encourage proactive participation in breast health. As high-risk patients are identified and educated, centers benefit from increased usage of advanced screening, like breast MRI, delivering return on investment for imaging equipment.
Help Families Prevent Cancer
When a genetic variant for hereditary cancer is found in a patient, it often impacts their entire family. Their close relatives are likely to be curious about their risk and happy patients are likely to send them to you for testing. Your imaging center has the opportunity to gain new clients, while your patients and their families gain the ability to be more proactive about protecting their health.
Gain Clientele Through Accreditation
National accreditation can help centers stand out from the competition and draw in patients through accredited referral networks. Imaging centers can keep current with or increase their ability to gain national accreditation by offering hereditary cancer screening and genetic testing. One of the The National Accreditation Program for Breast Centers (NAPBC) standards for accreditation specifies that cancer risk assessment, genetic counseling, and genetic testing services are provided or referred based on national guidelines during the site visit.
Natera Can Help
Natera partners with imaging centers to make it simple to offer high quality personalized breast cancer risk assessment by automating family history collection, providing access to Certified Genetic Counselors and making it easy to order, monitor, and receive results from the EmpowerTM Hereditary Cancer Test. NateraCore offers a wide range of flexible services that enable centers to incorporate genetic screening into their existing breast health program with streamlined workflows and comprehensive support.
Natera also provides patient education brochures, videos, and virtual learning tools to help imaging centers explain who is at risk for hereditary cancer, how the genetic testing process works, what to expect from test results, and what ongoing monitoring or preventative treatment could include.
Learn more about incorporating hereditary cancer screening to an existing high-risk breast care program or read about goal setting for high risk breast care programs.
References
1https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html. Accessed December 2021.
2Siu AL. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. U.S. Preventive Services Task Force [published erratum appears in Ann Intern Med 2016;164:448]. Ann Intern Med 2016;164: 279–96.
3https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing. Accessed January 2022.
4NCCN Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic practice guidelines. Version 2.2022
5National Comprehensive Cancer Network: Guidelines for Genetic/Familial Risk Assessment: Breast and Ovarian. Version 2.2019-July 30, 2018.
6https://www.cdc.gov/cancer/breast/young_women/bringyourbrave/pdf/screening_ct_guidelinesF.pdf. Accessed January 2022.
7National Cancer Institute. Cancer Stat Facts: Female Breast Cancer. https://seer.cancer.gov/statfacts/html/breast.html. Accessed February 2022.
8Childers C. et al. 2017. National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer. J Clin Onc. 35(34): 3800-3806.
9Cadiz F, Kuerer HM, Puga J, Camacho J, Cunill E, Arun B. Establishing a program for individuals at high risk for breast cancer. J Cancer. 2013;4(5):433-446. Published 2013 Jul 1. doi:10.7150/jca.6481.
10Scott D, Friedman S, Telli ML, Kurian AW. Decision Making About Genetic Testing Among Women With a Personal and Family History of Breast Cancer. JCO Oncol Pract. 2020 Jan;16(1):e37-e55. doi: 10.1200/JOP.19.00221. Epub 2019 Oct 15. PMID: 31613719.
11Haas JS, Kaplan CP, Des Jarlais G, Gildengoin V, Pérez-Stable EJ, Kerlikowske K. Perceived risk of breast cancer among women at average and increased risk. J Womens Health (Larchmt). 2005 Nov;14(9):845-51. doi: 10.1089/jwh.2005.14.845. PMID: 16313212.
12Katapodi MC, Dodd MJ, Lee KA, Facione NC. Underestimation of breast cancer risk: influence on screening behavior. Oncol Nurs Forum. 2009 May;36(3):306-14. doi: 10.1188/09.ONF.306-314. PMID: 19403452.