Contact Information

At Lancaster General Health, we're your partner in health and we're here to help you choose well to be well. Here's some information to get your started. 

To find an LG Health Physician:

  • Visit LGHealthPhysicians.org or call 1-888-LGH-INFO
     

To schedule a mammogram:

  • Visit LGHealth.org/Mammo or call (717-544-5941.
     

To learn more about the Penn Medicine Cancer Risk Evaluation Program:

  • Click here or call (717) 544-7444.
     

To learn more about the breast cancer program at the Ann B. Barshinger Cancer Institute:

  • Visit LGHealth.org/BreastCancer  or call (717) 544-9400.
     

To learn more about the Suzanne H. Arnold Center for Breast Health (breast imaging services):

  • Click here or call (717) 544-0322.

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About This Assessment

This profiler calculates 5-year and lifetime risk of developing invasive breast cancer and also categorizes these risk factors as either High, Moderate, or Low risk:

  • Lifestyle risk factors
    Postmenopausal BMI (weight), smoking, exercise, alcohol
  • Hereditary risk factors
    Ashkenazi Jewish descent, breast cancer in immediate family
  • Personal history
    Age, menstrual history, reproductive history, breast feeding, breast biopsy, hormone therapy

This profiler is intended only for women-specifically women who have NOT already been diagnosed with breast cancer, ductal carcinoma in situ (DCIS), or lobular carcinoma in situ (LCIS), or a BRCA1 or BRCA2 gene mutation. The results of this profiler are based on widely accepted research but are only accurate for the intended audience.

The breast cancer risk estimates are calculated using a woman's own age, ethnicity, personal medical history, reproductive history and the history of breast cancer in her immediate family. In general, breast cancer risk increases with age and with a longer lifetime exposure to the hormone estrogen. This profiler uses a statistical model known as the "Gail model," which is named after Dr. Mitchell Gail, Senior Investigator in the Biostatistics Branch of NCI's Division of Cancer Epidemiology and Genetics.

The Gail model has been tested in large populations of white women and has been shown to provide accurate estimates of breast cancer risk. In other words, the model has been "validated" for white women. It has also been tested in data from the Women's Health Initiative for African American women, and the model performs well, but may underestimate risk in African American women with previous biopsies. The model has been validated for Asian and Pacific Islander women. Researchers are conducting additional studies, including studies with minority populations, to gather more data and to test and improve the model.

The NCI Breast Cancer Risk Assessment Calculator may be updated periodically as new data or research becomes available. The algorithm was last updated in 2011. http://www.cancer.gov/bcrisktool/about-tool.aspx

The FDA has approved certain medications for the prevention of invasive breast cancer for women with an increased 5-year risk of breast cancer. Women at risk are defined as those with a 5-year breast cancer risk of 1.66% or higher (according to the Breast Cancer Prevention Trial sponsored by the National Cancer Institute). Because breast cancer risk increases with age, most women above the age of 60 have a 5-year risk of breast cancer that is higher than 1.66%.

Drugs used to lower the risk of breast cancer have possible side effects including hot flashes and increased risks of uterine cancer cataracts, and blood clots. In 2013, Guidelines from the United States Preventive Services Task Force (USPSTF) state that women who have a 5-year risk of 3% or higher for invasive breast cancer would have the most benefit and given the risks of the medication's side effects.

Recommendations vary as to how often to have a mammogram. In general, mammograms are suggested every 1 to 2 years starting at age 40 or 50. The American Cancer Society recommends that women who have a high lifetime risk of invasive breast cancer should talk to their health care providers about when to start breast cancer screening and if they would benefit by other imaging tests in addition to routine mammograms.


References

  1. Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Shairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst. 81(24):1879-86, 1989.

  2. Costantino JP, Gail MH, Pee D, Anderson S, Redmond CK, Benichou J, Wieand HS: Validation studies for models projecting the risk of invasive and total breast cancer incidence. J Natl Cancer Inst. 91(18):1541-8, 1999.

  3. Gail MH, Costantino JP, Bryant J, Croyle R, Freedman L, Helzlsouer K, Vogel V: Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer. J Natl Cancer Inst. 91(21):1829-46, 1999.

  4. Rockhill B, Spiegelman D, Byrne C, Hunter DJ, Colditz GA: Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention. J Natl Cancer Inst. 93(5):358-66, 2001.

  5. Gail MH, Costantino JP, Pee D, Bondy M, Newman L, Selvan M, Anderson GL, Malone KE, Marchbanks PA, McCaskill-Stevens W, Norman SA, Simon MS, Spirtas R, Ursin G, and Bernstein L. Projecting Individualized Absolute Invasive Breast Cancer Risk in African American Women. J Natl Cancer Inst. 99(23):1782-1792, 2007.

  6. Matsuno RK, Costantino JP, Ziegler RG, Anderson GL, Li H, Pee D, Gail MH. Projecting Individualized Absolute Invasive Breast Cancer Risk in Asian and Pacific Island American Women. J Natl Cancer Inst. 2011. doi:10.1093/jnci/djr154.

  7. Moyer VA. Medications to decrease the risk for breast cancer in women: recommendations from the U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159:698-708.

  8. Lee CH, Dershaw DD, Kopans D, et al. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol. 2010;7:18-27.

  9. American Cancer Society. Breast Cancer Early Detection 2014. Accessed at http://www.cancer.org/acs/groups/cid/documents/webcontent/003165-pdf.pdf on November 21, 2014.
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