Melanie: Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And today, we're offering important information to help you find out if you're at high risk for developing breast cancer. We're talking about the Ambry CARE High Risk Program and the Sheila R. Veloz Breast Center. Joining me is Dr. Anjali Date. She's a radiologist at Henry Mayo Newhall Hospital's Sheila R. Veloz Breast Center.

Dr. Date, it's a pleasure to have you join us today. This is such an important topic and you and I were even talking about it off the air as I'm in one of those risk groups. Can you tell us a little bit about the Sheila R. Veloz Breast Center at Henry Mayo Newhall Hospital and the Ambry CARE High Risk Program? What is that?

Dr. Anjali Date: Yes. Hi, thank you so much for having me. So, you know, we offer this really great program out of Sheila Veloz, where with Ambry Genetics, we can target a certain population of women in our community that are at high risk for breast cancer. So when a woman makes her appointment at the breast center, she would receive a text message from Ambry's Care portal. And that text message would then take her through a series of different questions, asking her her family history, any significant history of cancers. And it's not just breast cancer to note, it's other cancers like pancreatic, colon cancer, et cetera. And once she answers all of those questions, that's just documented in our care portal. And once the patient comes in, she is made aware of whether or not she meets the criteria to receive genetic testing for a certain number of genes that are associated with high risk of breast cancer.

Melanie: So give us a little lesson here, Dr. Date. What role does inherited trait play in developing cancer? And you mentioned a few other cancers, so there are some other cancers that have been linked to mutations in BRCA1 and 2. Explain a little bit about that. Clear up the confusion for us.

Dr. Anjali Date: Yeah. So it's not just BRCA or the BRCA gene that can have an increased risk for breast cancer. There's lots of other different types of genetic mutations and those different mutations can be associated with not just breast cancer, but other types of cancers. So when we are screening for the different questions to ask a woman, if she would have some genetic predisposition, we want to know the history of her family members that which pertains to not only just breast, but it would be colon cancer, pancreatic cancer. Those are the two sort of most common other types of cancers that we look at that flag for us whether or not she would meet criteria for testing.

Melanie: So tell us a little bit about some of the risk factors that are not genetically, you know, involved that would send a woman-- first of all, we got to be getting our mammograms. That's a fact, right? It's October, we're talking about this. But tell us some of those other risk factors that you take into account when you're taking that full medical history.

Dr. Anjali Date: Right. So actually your breast density does have a role in terms of your risk status. So we ask what your breast density is or we incorporate that from our mammograms that we know. In addition, if you've had children, if you're in premenopausal or menopausal state and also your ethnicity. So I know we were discussing this earlier, but Ashkenazi Jewish women do have an increased risk compared to other populations.

Melanie: So then how does this women identify the women who are at high risk? You said when we've done our mammogram, then we get a text message. Tell us a little bit about how you create that personalized breast cancer screening.

Dr. Anjali Date: Right. So if you answer all these questions and it does turn out that you would be a good candidate for testing, we offer that on the day of your mammogram, which is great. You come in, you get your mammogram. You get counseled by our staff who has been fully trained by the care program in terms of what to expect and the testing. And after your mammogram, you get your genetic test. It's a saliva test, so you do your sample and we send it through the care portal to get tested. Then once it's tested, you get your results via a chatbot, again through your cell phone. And your cell phone will say, "Your testing is available," and you are linked up with a genetic counselor to start to go through what is the best screening regimen for you.

So majority of these patients who do undergo testing test negative, no genetic component is there. And that's great. They can maintain their regular screening regimen of just coming in every year and getting their annual screening mammograms.

Now, a small percentage of those women test positive for some genetic predisposition. And that is where we really want to effectively screen for breast cancer in those women. So in those patients, a mammogram isn't enough. Usually what we recommend is additional testing with a screening MRI, and we would see those women every six months. So you would have an MRI let's say in January, and then six months later, you'd come back for a mammogram in June. And then again, six months later, you'd get your MRI. So basically, you'd be getting annual testing with MRI and mammogram, but we'd be seeing you every six months. So for these women that have an increased risk of breast cancer, we're really trying to effectively screen for those breast cancer, for those lesions.

Melanie: You know, that's so comforting to know that you would be so on top of it and see them with a screening MRI, which is such a definitive way. Now, obviously, a woman who does get that information, that just can be devastating to hear that you have this gene mutation. And I know that it's a genetic counselor's role to discuss what you do with that information. But you, as the radiologist, what do you want listeners to know about what you recommend that they do as far as family members, letting them know, discussing with a breast surgeon, possibly prophylaxis. You know, what would you like them to know about your discussions with them?

Dr. Anjali Date: Yeah. I mean, if you do test positive, there's a slew of information that is basically thrown at you. And, you know, the first thing that I would just say is digest all of it. Take it all in. Talk to your family members, talk to your friends about your diagnosis and talk to your primary care doctor or your OB, whoever that person is that's really sort of managing your care, managing your screening mammograms, because they would offer a lot of information too. If you talk to your family members and you go see your breast surgeon and you all come up with your plan together, then you'll feel less anxious and overwhelmed with all the different choices. Take your time with it. There's no rush to this. So the more information you have, I always feel that an informed person can be less overwhelmed.

Melanie: Tell us about your team, Dr. Date, because women, it's nice to feel enveloped and cared for. And that's what you're doing there at Henry Mayo Newhall Hospital. So tell us about all the people that are involved.

Dr. Anjali Date: Yeah, I love my team. I love everyone who works here at the Sheila R. Veloz Breast Center. You know, most of us are all from Santa Clarita. We live here. We have our families here. Our kids go to school here. So we have our front desk office. They're going to be the ones to first greet you when you come in. They're going to make sure that you filled out all your paperwork or your questions on that portal and answer any questions you may have about those screening protocols. If you, in fact, you know, aren't maybe very phone savvy, tech savvy, and you come in and you want to do it either with them in-person or in-office with our iPad, you could also do that. So they'll help you and talk you through each step.

Then we have our techs. Our technicians are the women who actually perform the exam. So they're going to be doing your screening mammograms, your screening ultrasounds, any diagnostic, additional studies that may, you know, be called for. And they're going to be the ones to also answer additional questions about the test itselt.

If you do meet criteria to get tested for genetic screening, then they're going to be the ones to administer the test, give you the sample, answer any questions you may have, make you feel at ease, and then you're good to go. And then I'm sort of the last step at the end, reading all the images and making sure that everyone's okay. It's a really nice atmosphere here because we care so much about the women in our community. Being from the community, living here, you know, you really feel a sense of home and you feel a sense of comfort. You feel like we're looking out for you. Like, you know, you're our friend, our neighbor, daughter, sister, mother, grandmother, et cetera.

Melanie: So thorough and comprehensive and compassionate all at the same time. Dr. Date, I can hear that. So wrap it up for us. What would you like women to know about the Sheila R. Veloz breast Center, consultations, the Ambry CARE High risk program, your best advice for women like me, Dr. Date, that are trying to decide we're getting our mammograms. We're doing what we should do, but we want to know if we should have that genetic test and then what we do with it. Give us your best advice.

Dr. Anjali Date: Yeah. You know, I always say that early detection is the best prevention in terms of helping treat breast cancers. And, you know, we want the women in our community to be screened effectively. And part of that is realizing that screening recommendations can't be one-size-fits-all, that the women in our community are diverse. Their health history is diverse, the family history is diverse, different risk factors. All of that plays into your role of how at risk you are in terms of developing breast cancer. And the higher risk that you have, the more we want to do to help make sure that we find something early, that we're screening and being on top of your breast health. And so this program helps us tailor make your own recommendations for screening. And that's what we want to do. We want to make sure that each woman has a specific program that we and they and their doctors have created for them to best prevent breast cancer.

Melanie: Such great information, so important. And thank you so much, Dr. Date, for joining us today and telling us about this program. And to schedule a consultation and to learn more about the Sheila R. Veloz Breast Center, please call (661) 200-1099. That's (661) 200-1099.

And that concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. You can always visit our website at henrymayo.com for more information and to get connected with one of our providers. Please ladies, share this show with your friends and family on your social channels. We're learning from the experts at Henry Mayo Newhall Hospital together. We all need to learn about this information so we can be our own best health advocates.

This is Melanie Cole. Thanks so much for listening.