Overview
Welcome to the Breast Cancer Prevention Center which provides prevention services and access to clinical trials.
Our mission is to improve the accuracy of individual risk assessment through the use of biologic markers and provide women with a variety of surveillance and prevention options.
The Breast Cancer Prevention Center is headed by Dr. Carol Fabian, an internationally recognized leader in risk assessment and early breast cancer prevention trials. The center brings together a variety of clinical, translational and basic scientists at the University of Kansas Medical Center. We also collaborate with top investigators in the field form other universities such as Baylor, Johns Hopkins, Duke, Yale, University of Alabama, Northwestern, and others.
All women are interested in their risk for developing cancer and what they can do to prevent that from happening. Most women visit the center for the first time for one or more of the following reasons:
A family history of breast cancer and want information about genetic testing
A prior precancerous biopsy or non-invasive breast cancer and want treatment options
They have hot flashes or other menopausal symptoms and are considering hormone replacement therapy
They have questions about screening frequency or types of screening tests
The first time a woman visits the center she usually has a consultation visit with one of our Breast Medical Oncologists. At this consultation we:
Gather information about your family and personal health history
Calculate your five and ten year risk with available information
Give you lifestyle and screening recommendations
Present standard and clinical trial prevention options
Perform a breast exam
Answer your questions
If your primary interest is in genetic testing, the initial visit may be with a genetic and cancer risk counselor. These consultations are generally covered by insurance.
For women who qualify and are interested, we may suggest a procedure called random periareolar fine needle aspiration (RPFNA) in which breast cells are removed through a very narrow needle under local anesthetic. This procedure helps detect precancerous changes (called atypia) and gives us a "snapshot" of changes occurring in your breast tissue. It may detect pre-cancerous change called atypia, but its purpose is not to detect early breast cancer. Women with atypia by RPFNA have an increased short-term risk for breast cancer, and may want to undergo more frequent surveillence or consider a prevention drug. Patients are required to have a mammogram within three months of the aspiration, and for premenopausal women, this should be on day 1-10 of the menstrual cycle. The mammogram can be with your usual provider or at KUMC, but patients must bring the films to the aspiration appointment.
There is no charge for a fine needle aspiration as it is covered by grants from foundations, the NCI, or donations from individuals.
If you are not a good candidate, or are not interested in standard prevention therapy (i.e. tamoxifen or raloxifene) you may be offered participation on one of several prevention clinical trial available. These include Phase III trials often widely available throughout the United States. All currently available Phase III trials are for postmenopausal women not on hormone replacement therapy. Multiple phase II trials are available through our prevention center. Some involve drug alternatives to tamoxifen, others involve natural product or behavioral interventions. Most are designed by our physicians and funded through the National Cancer Institute or national foundations such as: Avon or the Komen Foundation. Some research is funded by local foundations and events such as: Back in the Swing, Within the Ribbon golf tournament, the Kansas Masons, Eastern Star, Wives of the Veterans of Foreign Wars, and generous individual donors.
We will also help you make decisions regarding hormone replacement if you are having meopausal symptoms or are contemplating removal of your ovaries. At the present time, hormone replacement therapy is used only for women who have menopausal symptoms: hot flashes, mood swings, poor libido and/or vaginal dryness. The type of treatment used will depend on risk, age, and medical circumstances. The so-called bioidentical hormone replacement therapy means the hormones provided are the same chemical type that is made by the body. Estrogen alone used in women in their 40's and 50's or whose uterus had been removed is not associated with an increased risk of breast cancer. However, estrogen and progesterone in combinations even if bio-identical can modestly increase the risk for breast cancer. For those high-risk postmenopausal women needing estrogen or estrogen + progestin to control symptoms we have developed a prevention trial for them with an aromatase inhibitor called letrozole. A pilot study we performed and published was very encouraging.
We will give you suggestions for screening which you may follow with your primary care physician or at our center. We do have digital mammography, sonography and Breast MRI available.
We look forward to seeing you.