Now available at CPMC’s Breast Health Center: A new approach to personalized breast cancer prevention

California Pacific CURRENTS: The online journal of CPMC Research Institute

May 16, 2016

New federal and state laws require the reporting of breast density results from routine mammograms. Many women with normal or high breast density are confused or frightened by these results, and fearful of an elevated chance of getting breast cancer.

But recent evidence suggests only about half of women with dense breast tissue may have higher chances of developing breast cancer. According to CPMC Senior Scientist and San Francisco Coordinating Center Director Steve Cummings, MD, instead of looking at breast density alone, women and their doctors should also consider other factors when making decisions about additional screening and when weighing options to reduce the possibility of developing breast cancer.

Dr. Cummings and colleagues at CPMC's Breast Health Services Center have established the nation’s first and only approach to personalized breast cancer prevention based on a woman’s unique risk profile.  This approach is based on the premise that women have many options to prevent breast cancer – e.g., MRI, genetic counseling, diet, exercise, and medication – and that knowing one’s risk allows for personalized decision-making around these preventive options.

Other centers have research underway validating a similar approach but no other center has implemented it in clinical practice.

How it works

Women who undergo breast cancer screening at CPMC can obtain an action plan for personalized, breast cancer risk assessment (based on published research—the Breast Cancer Surveillance Consortium [BCSC] Model). This assessment estimates a woman's chances of developing breast cancer during the next five years, based on her medical history and family breast cancer history.

The tool incorporates breast density assessments and an online calculator that estimates a woman's risk of developing breast cancer, based on five parameters: age, race, breast density as reported from mammograms, whether she has ever needed a breast biopsy and whether her mother, sisters or daughters have ever had breast cancer.

The new approach can help inform women about whether supplemental screening by ultrasound or MRI should be considered, and/or if chemoprevention medications should be administered. 

So far, 18,000 women have enrolled in the program as part of their routine breast cancer screening at CPMC.