High Risk Program and Breast Cancer Prevention
The Dubin Breast Center’s Cancer Risk Evaluation Program (CaRE) is dedicated to helping individuals who are at high risk for developing breast cancer. This risk may be attributed to a variety of factors including genetic mutation or a personal or family history of cancer. The CaRE Program is affiliated with The Tisch Cancer Institute at Mount Sinai, The Mount Sinai Hospital, and the Icahn School of Medicine, which enables us to offer comprehensive services for risk assessment, cancer prevention, research, and education. Our Program helps people understand, reduce, and manage their risk for developing breast cancer.
Who Is Eligible?
Individuals who are eligible for the CaRE Program include those who have:
- An inherited gene mutation (BRCA 1 or BRCA 2) or other syndrome
- A personal or significant family history of premenopausal breast or ovarian or male breast cancer
- A breast biopsy or surgery revealing lobular carcinoma in-situ (LCIS) or atypical hyperplasia (ADH, ALH)
- A personal history of radiation therapy to the chest for lymphoma
Our Evaluation Process
After careful consideration of medical and family history, we create a personalized cancer risk profile to help guide each patient through the decision-making process regarding appropriate care. All possible options for risk reduction are discussed. Potential pathways based on one’s personal risk level may include: close surveillance with regular clinical evaluation and examination, risk-reducing medications (chemoprevention), or preventive (prophylactic) surgery. Some individuals may be referred for genetic counseling and possible testing.
Personalized, Multidisciplinary Care
Individuals enrolled in the CaRE Program benefit by receiving accurate assessment of their individual risk for developing breast cancer along with comprehensive, personalized plans for reducing their breast cancer risk, based on the most up-to-date information available. Patients also benefit by having the best chance for early cancer detection, when treatment is generally most effective. Located within one of the world’s premiere academic medical centers, we are also able to provide our patients with access to the latest advances in healthcare, including access to clinical research studies designed to develop novel preventive therapies for minimizing breast cancer risk.
Among the outstanding services offered at the Dubin Breast Center’s CaRE Program are:
- State-of-the-art breast cancer screening, including imaging with 3D mammography, ultrasound, and MRI
- Expert pathology review by specialized breast pathologists for patients with previous biopsy or those requiring biopsy
- Prophylactic surgery
- Intensive follow-up with surveillance exams and coordination of imaging
- Genetic counseling and testing by certified genetic counselors
- Support programs to address the physical and emotional needs of individuals living with breast cancer risk
- Breast cancer prevention clinical research studies designed to develop novel therapies for reducing breast cancer risk.
- Consultation with medical oncologists and plastic surgeons when indicated
- Nutrition and lifestyle counseling for risk reduction, focused on diet, weight loss and exercise
Dubin Breast Center Partners with BioMe to study Risk of Breast Cancer
The Cancer Risk Evaluation (CaRE) program at the Dubin Breast Center is designed for individuals at increased risk of breast cancer. Personalized risk management strategies may include high intensity surveillance imaging, drug therapy to lower risk, or prophylactic surgery. Investigators at our center have partnered with the Charles Bronfman Institute for Personalized Medicine’s BioMe Biobank Program to employ genomics for greater understanding of an individual patient’s cancer risk. The goal is a more precise determination of how risk factors vary among subpopulations and individuals. We expect this knowledge to lead to better personalized planning of how best to manage breast cancer risk. The BioMe Biobank Program was established in 2007 and has archived over 315,000 de-identified DNA samples (and over 370,000 de-identified plasma samples) from approximately 33,000 Mount Sinai patients, as of October 2015, that are paired with data from a questionnaire about activities of daily life and family medical history. The one blood sample collected as part of patients’ participation allows for DNA isolation and genotyping to analyze individual differences in sequence that may be important for cancer development in the future. This genomic discovery approach will also be useful to study breast cancer risk within distinct multi-ethnic populations. Patients who would like to participate in BioMe should ask their doctor, and our research staff will coordinate collection of a blood sample and questionnaire. Learn more
The Mount Sinai Hospital
1176 5th Avenue
New York, New York 10029