Self Regional Healthcare's Cancer Center is in the development phase for establishment of a high-risk breast clinic.
"Self's will be the only high-risk breast clinic in the Upstate," said general surgeon Dr. Kathleen Jeffery. "We're really at the forefront, hoping to identify those patients before they get cancer. This clinic's mission is to take aim at cancer before it happens."
An announcement about the High Risk Breast Clinic, part of Self Regional Healthcare's Breast Center, will be made during the hospital's Pretty in Pink celebration at the Piedmont Tech Medford Center on Tuesday.
This annual celebration benefits the Self Regional Healthcare Foundation‘s Breast Cancer Fund. It also honors breast cancer survivors and raises awareness about the importance of breast health.
For tickets, information, or registration for the hospital's on-site Mobile Mammography Unit, contact Erin Smith at 864-725-5977 or firstname.lastname@example.org.
Some key players in Self Regional's breast cancer care team have shared with the Index-Journal about this high-risk breast clinic, including Drs. Kathleen Jeffery and Ruiling Yuan, along with Erin Smith, a breast health navigator.
Dr. Jeffery is the medical director for Self Regional Healthcare's Breast Center.
To gauge high-risk potential earlier, Jeffery said when patients come for mammography screenings, everybody will be assessed for breast cancer risk, in part through completing a questionnaire.
"All patients who get a mammogram will fill out that questionnaire," Jeffery said. "That way, we are getting a great system of evaluating a huge group of patients we might not otherwise evaluate, if we just wait until they have an abnormality. This clinic is a way for us to let people know they are high-risk and what they can do about it."
Self Regional's breast health navigators will help determine patients' risk assessment based on completed questionnaires.
"If they meet a certain risk level, then they are candidates for our high-risk clinic, even without having had a biopsy," Jeffery said. "Our oncologists will see them and have an initial interview and make a game plan for them going forward."
Before the days of surveying patients early to gauge high-risk potential. Jeffery said she or another surgeon would do a breast biopsy of areas of concern detecting through screenings and that biopsy might reveal an atypical lesion.
"An atypical lesion basically flags a patient as high-risk," Jeffery said. "Those patients would then be referred to an oncologist to discuss cancer prevention care if that patient is at risk for developing cancer."
Those prevention plans, Jeffery said, could include genetic counseling, increased x-ray screenings and surveillance. Doctors in the community will also be able to make referrals.
Yuan said high-risk prevention could also include exercise and nutrition counseling as well as discussions about the use of drugs, vitamins, or other agents to try to reduce the risk of cancer.
"Part of this approach is screening of patients and part of it is risk-reduction," Yuan said.
"We have a great resource here with the Greenwood Genetic Center," Jeffery said. "We know 10 to 15% of patients have a genetic predisposition for breast cancer, but the rest are not. Twenty years ago, we were looking at two genes that can have links to other cancers. Now, we are looking at gene panels, or lists, with 84 genes."
Cancer prevention could include surgery, medication and screenings, according to hematology specialist and medical oncology specialist Dr. Ruiling Yuan, with Self Regional's Cancer Center.
A family history of a number of types of cancer can put one at greater risk for development of breast and other cancers, Jeffery said.
If a woman has never been pregnant, never breast-fed and has taken estrogen in some form, those could also increase her risk for breast cancer, Jeffery said.
Yuan said other modifiable risk factors include being overweight, lack of exercise and drinking excessive amounts of alcohol.
"A lot of risk factors for breast cancer you can do something about," Jeffery said. "For example, if you breast feed, you can potentially reduce your risk for breast cancer."
Erin Smith, a breast cancer navigator with Self Regional, said navigators help make sure high-risk patients get to yearly screenings, oncology evaluations and risk reduction measures.
"Patients have an opportunity to be coached by medical oncologists on how to reduce their risks," Smith said. "But, coming to the high-risk breast cancer clinic does not mean those patients have cancer."
"The clinic is a positive for those who need a close watch to make sure they don't get breast cancer," Jeffery said. "It's for patients who have medical histories that make them high-risk. The goal of the high-risk clinic is to take aim before cancer starts. If we can prevent two breast cancers a year because we do this, that is worth it. Now, Self also has three-dimensional mammography, too, and you don't get a lot of false-positives with that. Yet, there are a lot of people who still are not getting mammograms. Many times, that is because people put their own health on the back burner. We want to provide all the elements we can to take care of breast health, whether it's prevention or benign breast disease or malignant breast disease."
To help reduce false positives, Self Regional also has a person dedicated to breast imaging full-time, Smith said.
The close watch approach is echoed by the likes of the U.S. Preventive Services Task Force with regard to breast cancer risk reduction, according to Yuan.
"If you catch things earlier, you can prevent death," Yuan said. "There's more and more evidence-based data, which we can put into practice, to deliver more effective ways for reducing risk of breast cancer."
Yuan also has previous experience and training with a high-risk breast clinic affiliated with Baylor University in Texas.
A long-term goal for Self Regional is to have a free-standing breast health facility, Jeffery said, but comprehensive breast health is already a part of what the hospital offers, including advances such as 3-D mammography.