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Identification and Management of the High-Risk Patient


Wednesday, April 6
8:00 AM–4:30 PM
Course Moderators: Amy Cyr, MD, FACS; Eric Manahan, MD, MBA, FACS
Faculty: Anne-Corinne Beaver, MD, FACS; Amy Cyr, MD, FACS; David Euhus, MD, FACS; Christine Laronga, MD, FACS; Eric Manahan, MD, MBA, FACS; Janice Sung, MD; Jeffrey Weitzel, MD

Course Description:

This course will discuss components of breast cancer risk, including genetic predisposition and lifestyle choices, and how to best identify high risk women. The course will cover options for and barriers to high-risk screening. Multiple options for risk reduction will be discussed, including endocrine prophylaxis, risk-reducing mastectomy, and lifestyle counseling.

Course Objectives:

At the conclusion of this course, participants should be able to:
  • Discuss the multiple components of breast cancer risk, including genetic predisposition, race, breast density, and obesity.
  • List guidelines for screening high-risk women and understand barriers to high-risk screening, including those that contribute to healthcare disparities.
  • Competently offer and manage endocrine prophylaxis in appropriate patients.
  • Counsel patients on multiple options for reducing breast cancer risk.

CME Information:

The American Society of Breast Surgeons designates this live activity for a maximum of 6.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Agenda:

7:30 AM Check-in and Breakfast
8:00 AM Welcome and Introduction
Amy Cyr, MD, FACS; Eric Manahan, MD, MBA, FACS
8:10 AM Risk Factors (including density) and Risk Models
Amy Cyr, MD, FACS
8:30 AM Challenge and Approach to Global Implementation Genomic Cancer Risk Assessment
Jeffrey Weitzel, MD
8:50 AM Incorporation of High-Risk Lesions Into Risk Assessment
Amy Cyr, MD, FACS
9:10 AM Increased Precision and Challenges From Polygenic Risk Scores
Jeffrey Weitzel, MD
9:50 AM Moderately Penetrant Genes
David Euhus, MD, FACS
10:20 AM Q&A
10:35 AM Break
10:50 AM MRI (who for, benefit, gadolinium, cost, accessibility, disparities)
Janice Sung, MD
11:20 AM US (who for, benefit, techniques, cost, accessibility)
Janice Sung, MD
11:35 AM Other Imaging (who for, contrast-enhanced mmg, abbreviated MRI, etc.)
Janice Sung, MD
11:55 AM Q&A
12:10 PM Lunch
1:10 PM Which Endocrine Therapy for Which Patient
Amy Cyr, MD, FACS
1:30 PM Tamoxifen/Raloxifene (dose options, contraindications, monitoringwhile on therapy, management of side effects)
Eric Manahan, MD, MBA, FACS
1:45 PM Aromatase Inhibitors (contraindications, monitoring while on therapy, bone health, management of side effects)
Eric Manahan, MD, MBA, FACS
2:10 PM Role of Mastectomy and Recommended Post-mastectomy Surveillance
Christine Laronga, MD, FACS
2:25 PM New Opportunities in Risk Management (genomic profiling, genetic research registries, other clinical trials)
Christine Laronga, MD, FACS
2:40 PM Break
2:55 PM Diet/Obesity/Exercise
Anne-Corinne Beaver, MD, FACS
3:15 PM Tools to Encourage Lifestyle Change
Anne-Corinne Beaver, MD, FACS
3:35 PM Common Patient Questions (safety of HRT, vaginal estrogen, soy, etc.)
Amy Cyr, MD, FACS
4:05 PM Q&A
4:30 PM Adjourn