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Fall 2006 Early Warning SystemAAMC’s Risk Assessment and Prevention Program (RAPP) helps women stay one step ahead of breast cancerWith each passing month, research efforts provide physicians and scientists with fresh insights in the crusade against breast cancer. These insights include advances in the treatment of the disease as well as new information about the genetic and molecular factors that cause the disease.
Factors that increase the risk for breast cancer:
In addition, awareness and prevention programs have led to more women having screenings performed at an earlier age. The good news is that the five-year survival rate for breast cancer detected in its early stages now tops 90 percent. Still, the rate of breast cancer incidence has risen steadily over the last several years. According to the National Breast Cancer Foundation, in 1960 the incidence of breast cancer was one woman in 20; today it’s one woman in eight. Opinions vary as to the reasons for the increase, from the simple fact of more women being screened at earlier ages to environmental or lifestyle issues and demographic trends. Whatever the reasons, the link between higher rates of breast cancer and the proven benefits of early detection underscores the importance of a program at Anne Arundel Medical Center that helps women determine their individual level of risk for developing breast cancer. Called the Risk Assessment and Prevention Program (RAPP), the program enables women whose medical or family history includes certain risk factors to have their overall breast cancer risk evaluated. Tana Yates, C.R.N.P., assisted by Heather Travis, C.R.N.P., coordinates the RAPP program at AAMC. Ms. Yates says that enough is known about the genetic and statistical links to breast cancer that “a realistic risk assessment can be made that helps guide appropriate planning for breast cancer risk reduction and early detection steps.” 
Nurse practitioners Tana Yates (center) and Heather Travis (R) discuss risk assessment and prevent of breast disease with high risk patients. “The first step is making women aware of the program,” she said, “and then letting them know that there are active steps we can take to improve their odds once an evaluation shows the risk is there.” Following the initial visit and an assessment of risk by a RAPP specialist, a range of individually tailored risk reduction and management options are available. “Depending on our assessment and the recommendations of physicians in the various cancer specialties if they become involved, we can implement a plan that might include tamoxifen (Nolvadex) or raloxifene (Evista) as preventative drugs, changes in diet and lifestyle, and perhaps more frequent clinical breast exams along with current breast imaging techniques,” said Ms. Yates. Lorraine Tafra, M.D., medical director of the AAMC Breast Center, says RAPP gives women who know or suspect they may be at risk “a choice beyond simply waiting or wondering. RAPP is a way for them to take control and connect with a process that helps them cope with the emotional issues of breast cancer risk.” |
