Breast Cancer Risk Assessment and Prevention

We consider these and other factors in a comprehensive evaluation and assessment and then use the findings to determine if you are at average risk or high risk for breast cancer. Based on this assessment, we create a personalized plan to address your needs.

• Inherited mutations in certain genes, such as BRCA1, BRCA2, and others associated with breast cancer.
• Family history of breast cancer-- a close relative (parent, sibling, child, aunt, uncle, cousin) with breast cancer.
• Changes seen in breast biopsies or precancerous conditions that affect the cells in the breast.
• Radiation treatments to the chest area as an adolescent or young adult.

Other factors that increase your risk include:

• Your sex (assigned at birth) and age.
• Weight, diet, alcohol, and exercise habits.
• Dense breast tissue on a mammogram.
• Age of first menstruation, pregnancy, and menopause.
• Use of hormone replacement therapy.

Average Risk
If you are at average risk for breast cancer, you will be given a schedule for routine screening under the care of your primary care team.

Above Average or High Risk for Breast Cancer
If you're at above average or at high risk for developing breast cancer, we may recommend a schedule for long-term follow-up in our clinic to help manage your risk and provide close monitoring if you develop breast cancer. This may include regular mammograms and other advanced breast imaging techniques so we can monitor for changes and detect tumors earlier in your breasts. We may also recommend one of the following risk-reducing strategies.

Lifestyle Changes
Our team can help you make diet, exercise, and/or other lifestyle changes such as quitting smoking that can lower your risk.

Risk-Lowering Medication (Chemoprevention)
Tamoxifen, raloxifene, and aromatase inhibitors have been shown to lower some women’s risk of breast cancer. Sometimes these risk-reducing medications are referred to as “chemoprevention.”

Risk-Reducing Prophylactic Mastectomy
If this is right for you, you’ll meet with one of our breast surgeons to understand your options, such as “going flat” or undergoing breast reconstruction. If you are interested in breast reconstruction, you will also meet with one of our plastic surgeons to discuss which technique is best for you.

Virtual Educational Webinar
Patients at our breast risk assessment clinics can participate in monthly interactive, educational webinars that are held online using Zoom. They are facilitated by a breast care provider who leads group discussions on topics such as breast cancer risk, nutrition, genetics, anxiety related to being at high risk, and more. Other Duke providers may also participate in these sessions to provide focused education on featured topics.

Clinical Trials
We will let you know if you are eligible to participate in clinical trials related to your breast cancer risk factors, such as new ways to prevent or diagnose breast cancer.

Support Services
We offer the full range of services to give you the support you need to cope with the emotional and psychological effects that may be associated with learning your breast cancer risk.

Specialized Care for Young Women at High Risk for Breast Cancer
Women ages 45 and younger may face additional considerations such as fertility preservation. If needed, we can refer you to our oncofertility specialists who can discuss your options and recommend an approach that is right for you.

Comprehensive Breast Cancer Care
If an abnormality is identified, you may be referred to the breast specialists at our breast clinics. You will have immediate access to the entire scope of our nationally recognized breast cancer program.