Breast cancer risk assessment technology at Mercy Women’s Center first of its kind in the Corridor

This story first appeared in Healthy You - November 2024, The Gazette’s quarterly health publication.

When it comes to being proactive about breast cancer prevention, the effort at Mercy Women’s Center is now even more precise thanks to new software.

Volpara Risk Pathways is described as a state-of-the-art assessment tool that identifies women who may be at elevated risk for breast cancer, and Mercy Cedar Rapids is the first hospital in the area to offer it.

“ Before this technology, determining a woman's risk for breast cancer was not part of annual mammogram screening. It is so important to determine a woman's risk for breast cancer to ensure the appropriate and most accurate cancer screening is available and recommended,” explained Amie Hass, high risk oncology genetics nurse practitioner. She added that this software does not estimate cancer risk in women previously diagnosed with breast cancer.

The mammogram analysis produces a breast density standardized score.

“This way, there is consistency in how we analyze breast density. Per federal and state guidelines, we have to score density into four categories: fatty, scattered fibroglandular densities, heterogeneously dense, and extremely dense,” said Dr. Robert Dolan, a radiologist at Mercy. “This software makes this analysis more objective than before, where it was more subjective. The radiologist can override this score if we think it is inaccurate.”

The computer software is integrated with Mercy Medical Center's electronic medical record system. Before a screening mammogram, a patient completes an electronic check-in process using the MyChart App on a smartphone or tablet at the Women's Center. The simple check-in process asks the patient questions about their personal history and family history.

“The software then will gather these responses and estimate the lifetime risk for breast cancer using a breast cancer risk assessment model. The estimated risk is then part of the woman's mammogram result and reported to her health care provider,” detailed Hass.

According to Mercy, breast cancer affects one in eight women during their lifetime, underscoring the importance of not only regular mammography screenings but a comprehensive understanding of individual risk factors.

The software benefits to patients include:

Once a patient’s risk information is collected, Mercy utilizes a set of risk models and clinical guidelines to accurately identify and direct high-risk patients to follow-up care, which may include genetic testing and/or additional imaging, such as ultrasound or breast MRI. This ensures that every patient receives a customized care plan based on their unique risk profile.

“This takes several things into consideration when calculating a lifetime risk for breast cancer score. Examples of things it uses to calculate this score are family history and estrogen exposure,” Dolan said. “We recommend anyone with over a lifetime risk of 20 percent be screened additionally with annual contrast enhanced breast MRI. Breast MRI is our most sensitive imaging modality to find breast cancers.”

Hass, who works at the Hall Perrine Cancer Center, has been a genetics nurse practitioner for nine years. She meets with patients who have a personal and/or family history of cancer.

“I hear so many women express their concern for breast cancer risk. Many women will say, ‘It is not if I develop cancer, but when I develop cancer.’ Breast cancer risk assessment will ensure these women will have the knowledge and understanding of their cancer risk. This knowledge will ensure these women can be proactive in their care,” Hass said.

Dr. Dolan said the key is finding women who are at elevated risk of breast cancer who do not know that they are, then making sure they get the most appropriate screening available.

“It is a national trend that breast cancer and many other cancers are occurring in younger patients. With this, we occasionally see advanced breast cancers in women of all ages. Our goal is to get all local women the screening they need in order to diagnose cancers as early as possible in as many women as possible. The smaller the cancers that we find, the better the outcomes our patients will have,” he added.

Advances in screening are key to Hass, she said, because they now have the ability to possibly prevent cancer with risk reducing interventions such as preventative surgery.

“This technology has the ability to determine if a woman would benefit from cancer genetic testing,” she said. Cancer genetic testing may determine a woman has a very high risk for breast cancer, such as a BRCA1 gene mutation. Women with a BRCA1 gene mutation may have 60 percent risk for developing breast cancer by age 80.”

For more information, visit mercycare.org/breastriskassessment.