Breast Cancer Awareness: Going Beyond the Annual Mammogram

Advanced Cancer Screening at Breast Health Center Gives Marin Women Extra Layer of Protection

GREENBRAE, CA — Marin General Hospital’s Breast Health Center, one of only a few centers in the Bay Area that offer a computerized advanced risk identification program to all women at the time they receive their annual mammograms, is seeing the type of results the program intended when it began 18 months ago.

According to the Center’s medical director, breast surgeon Leah Kelley, MD, approximately 15% of women screened during that time have been identified as having an elevated risk for breast cancer. Many of these women are now participating in personalized follow up plans that include options such as lifestyle counseling, genetic testing and advanced diagnostic tests.

Breast cancer prevention guidelines have traditionally advised all women to do breast self examination, have a yearly clinical breast exam beginning at age 25 and an annual screening mammogram beginning at age 40, says Dr. Kelley. However, there is increasing data that suggests that these recommendations should be individualized based on personal risk factors such as family history, genetic mutations or dense breast tissue, she adds. New guidelines include recommendations that women receive personalized risk factor identification and to be informed about how breast density can affect mammography readings. 

“With Marin County’s higher than average per capita incidence of breast cancer and the concentration of women in this area potentially at high risk, our team of breast specialists took the responsibility to start this program. We felt strongly that the Breast Health Center needed to be at the forefront of these new recommendations for the prevention of breast cancer.”

The high risk screening program is available to each woman coming to the Center for her annual screening mammogram. As part of her appointment, she is asked to complete a risk factor questionnaire. Risk assessment software is then used to identify personalized breast cancer risk. Women with an elevated risk are then offered a consultation with nurse practitioner Maria Dalmacio to discuss next steps, including the development of an individualized diagnostic screening and treatment plan. Those found to be at particularly high risk are referred for consultation with Dr. Kelley. The results of the risk identification questionnaire are automatically included the screening mammogram report sent to the woman and her referring primary care physician.

According to the American Cancer Society, breast cancer is the most common cancer among U.S. women except for skin cancers. Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer. Women at average risk have a 12% lifetime risk for breast cancer; any woman whose lifetime risk exceeds 20% is considered at high risk. Currently there are 2.8 million breast cancer survivors in the U.S. with a history of breast cancer, some cancer-free, others still under treatment.

“Early identification is the key,” says Dr. Kelley. “Our goal at the Breast Health Center, especially located as we are in Marin County, is to be as proactive as possible in breast cancer prevention, diagnosis, and treatment so we are able to give women that all important extra layer of protection against the disease.”

Marin County women diagnosed with breast cancer have another advantage with the comprehensive treatment options available to them at Marin General Hospital, Dr. Kelley adds. Earlier this year, the Marin Cancer Institute at Marin General Hospital, continuously accredited since 1985, received another three year Accreditation with Commendation, the highest level of recognition from the American College of Surgeons’ Commission on Cancer (CoC). Only about 30% of all U.S. hospitals, most at academic centers, have accredited cancer programs. Marin Cancer Institute earned the Outstanding Achievement Award with its past 2 accreditations in 2008 and 2011—an award earned only by an elite group of accredited cancer programs.

“This commendation demonstrates that right here in Marin County, at Marin General Hospital, we are providing a level of breast care and expertise on par with that of the finest hospitals in the country,” says Dr. Kelley. 

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