Abstract P3-03-07: The Breast Cancer Prevention Clinic: A Single Institution’s Experience

Abstract The Breast Cancer Prevention Clinic: A Single Institution’s Experience Authors: Joe J. Stephenson MD1, LeAnn Perkins, FNP-BC, DipACLM1, Erinn Crowe, RN, BSN, OCN1, Regina Franco, MSN, NP-C, DipACLM1, Pamela Cloys, MSN, ANP-C1, Carmen Hancock, MSN, APRN, FNP-C, AOCNP1, Marie Smith, MS1 1Prisma Health Cancer Institute, Center for Integrative Oncology & Survivorship Background: Roughly 1 in 8 women will be diagnosed with invasive breast cancer in their lifetime1. Some women have higher risk for developing breast cancer due to numerous factors such as elevated risk modeling scores, a history of chest radiation therapy, a history of atypical cells on a breast biopsy or a pathogenic genetic mutation. Enhanced surveillance to detect cancers early and addressing modifiable lifestyle risks are helpful to mitigate risks. Methods: The Prisma Health’s Breast Cancer Prevention Clinic (BCPC) approaches prevention by monitoring non-modifiable risks with regular surveillance and education on optimizing lifestyle habits to decrease modifiable risks. Established in 2017, the BCPC team now includes multiple medical oncologists and nurse practitioners, allowing the clinic to be offered any day of the week. During the visit, patients receive a personal risk assessment. Recommendations are given for surveillance imaging, risk-reducing endocrine therapy, and risk-reducing lifestyle modifications such as diet, alcohol consumption, and exercise routines. Family history is also reviewed to recommend Genetic Counseling if appropriate. In March 2022, a statement was added to patient mammograms, generating referrals for those with calculated elevated risk (a calculated lifetime risk >20% using the Tyrer-Cuzick or International Breast Cancer Intervention Study model and/or a 5-year risk >1.7% using the National Cancer Institute Breast Cancer Risk Assessment Tool or Gail model). Results: In a 12-month period from June 1, 2021 through May 31, 2022, 56.2% of patients were referred based on family history, 26.9% for higher-risk breast pathology, 8.1% for calculated elevated risk, 4.4 % for a pathogenic genetic variant that increases breast cancer risk and 4.1% for mammographic identification risk modeling. Following the BCPC visit, referrals for patients may include imaging such as mammograms, MRIs, genetic counseling or testing, or surgical evaluations. Referrals for lifestyle modifications may include nutrition, exercise navigation, mindfulness classes, or Sexual Health Evaluations. From June 2021 through May 2022, 41.4% of patients were referred for a breast MRI, 26.6% were referred to genetic counselors for genetic testing recommendations, 11.1% were referred to nutrition or exercise services, 8.42% were referred for a Bone Density Scan (DXA), 4% were referred to a Breast Surgeon and 3.7% were referred to the Genetic Management Clinic. Additionally, 79.5% of patients were referred to the High-Risk Breast Lifetime Clinic for continued monitoring and surveillance for early detection of breast cancer, continued reinforcement of lifestyle modifications, and management of risk-reduction endocrine therapy. Conclusion: The unique structure of this model allows for enhanced surveillance through greater use of evidence-based cancer prevention, early detection methods, and increased education for lifestyle medicine practices with the overall goals of reducing breast cancer risk, earlier breast cancer detection, and increasing quality of life. Reference List 1. DeSantis C, Ma J, Gaudet, M, et al. Breast cancer statistics, 2019. CA: A Cancer Journal for Clinicians. 2019;69(6), 438-451. https://doi.org/10.3322/caac.21583. Citation Format: Joe Stephenson, LeAnn Perkins, Erinn Crowe, Regina Franco, Carmen Hancock, Pamela Cloys, Marie Smith. The Breast Cancer Prevention Clinic: A Single Institution’s Experience [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-07.