Nurse practitioner Angela Ball is part of Memorial Health System’s Department of Surgical Oncology, where she specializes in supporting patients with high-risk breast conditions. She provides education, guidance and personalized care for those navigating breast cancer risk, benign breast lesions and overall breast health.

What does it mean to be “high risk” for breast cancer?

Being “high risk” for breast cancer means having a significantly elevated probability of developing breast cancer compared to the general population based on clinical risk models (such as a high GAIL score), personal history or genetic factors. Additionally, those with known pathogenic gene mutations, history of chest radiation between the ages of 10-30, a personal history of a high-risk breast lesion or a strong family history of breast cancer are also considered to be at a high risk.

Other risk factors – like dense breast tissue, early menstruation, late menopause or certain aspects of reproductive history – can also increase your risk.

What is a GAIL score?

A GAIL score is a quantitative estimate of a woman’s absolute risk of developing breast cancer over the next five years and up to the age of 90 (lifetime risk). They are automatically calculated whenever a mammogram is completed at Memorial Health System.

What should a person do if their GAIL score shows a higher-than-average lifetime risk?

They should discuss risk-reduction strategies and increased surveillance recommendations with their provider. We offer a High-Risk Breast Clinic located in our Department of Surgical Oncology, where a personalized preventative plan can be developed.

What are high-risk breast lesions, and how are they typically found?

High-risk breast lesions are abnormal changes in breast tissue that are not cancerous but are associated with a higher-than-average risk of developing breast cancer in the future. These lesions are usually found during a biopsy for another issue, like an abnormal mammogram.

If someone does have high-risk breast lesions, does that mean they will develop breast cancer?

An individual with a high-risk breast lesion is not guaranteed to develop breast cancer–in fact, most will not–but they do have a significantly higher risk than the general population.

What does management look like for someone diagnosed with a high-risk lesion?

Management of high-risk breast lesions is individualized and should be based on multidisciplinary reviews. Surgical excision is generally recommended for some types of lesions but is normally reserved for unusual or unclear cases, while others are typically managed with imaging surveillance.

All patients with high-risk lesions should receive counseling regarding their breast cancer risk as well as annual mammography and other risk-reducing strategies such as chemoprevention and the addition of annual MRIs, depending on the overall risk profile.

If someone is considered high risk, what steps can they take to stay proactive about their breast health?

Individuals who are considered high risk should speak with their health care provider about risk reduction and prevention. Clinical breast exams should be performed every six months, as well as self-breast exams monthly. Patients should practice breast awareness and report any changes to breast health, which may include new onset nipple inversion or retraction, nipple discharge, skin changes, breast pain or axillary masses. Vigilance with imaging surveillance is important, including annual mammograms and any additional imaging that has been recommended.

How can people advocate for themselves if they are concerned about their risk?

Speak up for yourself! Do not be afraid or embarrassed to verbalize any breast health concerns. If you are having any concerns, see us at the High-Risk Breast Clinic or call 740-374-7985 to speak with one of our team members!