Breast Cancer Risk Assessment and Prevention

Specialized Clinic for People at Increased Risk for Developing Breast Cancer

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You have been seen by a Duke provider for breast cancer within the last three years or you need to reschedule an appointment.

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Knowing your risk for developing breast cancer is important for everyone, but it is essential if you have one or more factors that put you at high risk. Knowing your risk is the first step in creating a personalized screening and risk-reducing care plan. It will also ensure breast cancer is detected early and effective treatment is started promptly.

Duke Health’s Breast Risk Assessment Clinics are staffed by specialists who are trained and certified to assess breast cancer risk in men and women, typically under the age of 70, and have never been diagnosed with breast cancer. We tailor a plan that includes screening, counseling, and other resources to help you manage your breast health.

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Factors that Increase Your Risk for Breast Cancer

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.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

What to Expect at Your Comprehensive Consultation

Your first appointment at one of our breast risk assessment clinics will include a comprehensive consultation with a breast risk specialist via a video visit or in-person visit. We will take a thorough family history, and medical history, recommend breast imaging tests, and discuss genetic testing. If you also have an active breast symptom, such as a breast lump or pain, you may first be evaluated faster in another breast clinic before meeting our high-risk specialists.

Breast Imaging

  • 3D screening mammography
  • Diagnostic contrast-enhanced mammography
  • Screening and diagnostic breast ultrasound
  • Breast MRI and fast breast MRI

If you are a return patient, we may get the results of these tests before or during your visit so that they can be discussed as part of your follow-up visit.

If you are a new patient, we will review the breast imaging ordered by other providers and the results as part of your consultation.

Genetic Counseling and Testing

We may refer you to one of our genetic counselors if you have a family history of cancer, or your doctor suspects a genetic mutation may be present. Our certified genetic counselors work closely with you to assist with the genetic testing process and provide counseling to help you understand how the results impact your risk.

New Patient Appointment

Your Personalized Breast Risk Assessment Plan

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.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 11/16/2023 by