Breast Cancer Navigator Program

Breast Cancer Navigator Program

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Am I at Risk for Breast Cancer?

There is really no way to know for sure if you’re going to get breast cancer. Certain risk factors can make it more likely, but having 1 or more does not necessarily mean that you will get breast cancer. In fact, you can have all the risk factors and never get breast cancer, or you can have no known risk factors and still get the disease.

If you agree with any of the following bolded statements, you may be at an increased risk of developing breast cancer. Some risk factors are out of your control, such as your age or family history. Others, like drinking 1 or more alcoholic drinks a day, or taking hormones, are factors you can control.

Each time you agree with a statement, ask yourself if you are doing all that you can to control that particular risk factor. It may seem difficult, but your efforts can have a big payoff in terms of your health and quality of life. Ask your health care providers and loved ones to help think of ways that you can lower your risk for breast cancer.

Know that researchers continue to study some of these factors to determine how much they can increase your risk for breast cancer. In some cases, more studies are needed to confirm the link to breast cancer.

I’m a woman

Both men and women can get breast cancer. But most of the cases occur in women. Being a woman is the main risk factor for breast cancer.

I’m older than age 50

Age is your next biggest risk factor. The older you are, the more likely you will get the disease. In fact, most breast cancers are found in women older than age 55. Though you can’t do anything to reduce this risk factor, you can avoid those risk factors that are in your control.

I’ve had breast cancer

If you’ve had cancer in 1 breast, you’re at an increased risk of getting it in the other breast. Keep all your follow-up appointments with your health care provider and have yearly mammograms.

A female relative has had breast cancer

If any female relative in your family (including your grandmother, mother, aunt, sister, or daughter) has had breast cancer, you have a higher risk of getting it, too. Your risk doubles if the woman is your mother, sister, or daughter. And it’s even higher if your relative had cancer in both breasts, or if it was diagnosed before she went through menopause. Research shows a genetic link between women in the same family who have breast cancer. If breast cancer runs in your family, you can have genetic testing to find out if you have that abnormal gene. If you do, you can explore options to help prevent the disease. But just because you have the abnormal gene doesn’t mean you’ll get breast cancer. Therefore, it’s best to have genetic counseling first to know whether or not to get tested, and to know what to do after testing. Some women choose to have 1 or both breasts surgically removed. Removing a healthy breast as a preventive measure is called a prophylactic mastectomy. Since surgery carries its own set of risks, talk this option over carefully with your doctor before making a decision.

I have benign breast disease

There are 2 kinds of benign breast disease: nonproliferative and proliferative. Nonproliferative benign breast disease does not increase your risk for breast cancer. But if you have proliferative benign breast disease, your risk for breast cancer increases. Proliferative benign breast disease is an overgrowth of cells lining your ducts or lobules. If the multiplying cells look like normal breast tissue cells, your risk only increases by 1.5 to 2 times. If your cells look abnormal (called atypia), then your risk increases by 3.5 to 5 times. The only way to know if you have benign breast disease is by having a biopsy.

I’m older than age 30 and have never given birth

If you’re older than age 30 and you’ve never given birth to a child, you have a slightly higher risk of getting breast cancer. Evidence shows that your risk decreases the more children you have and the closer in age you have them. However, because so many factors should be considered before having a baby, you may be better off focusing on the other risk factors that you can control.

I take hormone replacement therapy (HRT) drugs

HRT involves taking the hormones estrogen or progesterone, or a combination of the two. If you have taken combination HRT for 2 or more years to relieve postmenopausal symptoms, you may have a greater chance of getting breast cancer. And the longer you’ve taken them, the higher your risk. The good news is that if you stop taking the drugs, your risk should go back down to normal after 5 years. Estrogen alone, which may be given to women who no longer have a uterus, does not appear to raise your risk much, if at all, unless it is taken for a long time (for more than 10 years). Talk with your health care provider about how to gradually stop taking HRT. This will help lessen the side effects that can occur if you stop suddenly.

I started having periods before age 12 or didn’t reach menopause until after age 55

Researchers think that the longer your breast tissue is exposed to estrogen, the more likely it is that you will get breast cancer. If you’re menstruating, it means your ovaries are still producing estrogen. This is a hormone that increases your risk for breast cancer. Therefore, the longer you have been having your period, the higher your risk. 

My chest has been exposed to high-dose radiation

If you have ever been exposed to high-dose radiation in your chest area, you have an increased chance of getting breast cancer. This may be true if you were treated for Hodgkin disease, took part in certain tuberculosis studies, or lived near the site of an atomic blast. And the risk may be even higher if the exposure happened when you were a child. It’s important to remember that this involves high doses of radiation. The small doses used for breast cancer screening, for example, do not increase your risk.

I’m white

If you’re white, you have a higher risk of getting breast cancer than if you’re black, Asian, or Native American. But if you’re black, your risk of dying from the disease is higher than it is for white women. Studies also show that when women from low-risk countries move to a high-risk area (like the United States), their risk for breast cancer goes up. This probably means that environment and lifestyle factors matter more than the genetics of these groups in determining risk.

I’m overweight

This risk factor is complex. Research shows conflicting results about the link between weight and breast cancer. Overall, your risk of getting breast cancer is lower if you maintain a healthy weight with a body mass index below 25. If you’re overweight and you do get breast cancer, the excess weight also affects your chances of being cured. Most health care providers say it’s better to maintain a healthy weight. If you’re overweight, ask your health care provider or a nutritionist for tips on how to get more exercise and eat fewer calories so you can shed pounds. Make an effort to avoid gaining weight after menopause.

I take birth control pills

Studies show that taking birth control pills slightly increases your breast cancer risk compared with women who have never used them. The risk seems to go back to normal over time after the pills are stopped. Women who stopped using birth control pills more than 10 years ago have not been found to have any increased breast cancer risk. Talk with your health care provider about the benefits and risks of taking oral contraceptive pills.

I drink one or more alcoholic drinks a day

Studies show that your risk for breast cancer goes up if you drink just 1 glass of wine or beer or 1 mixed drink a day. Studies also show that the more you drink, the greater your risk. If you do drink, limit yourself to less than 1 drink per day. If you have a family history of breast cancer, you may want to limit your intake even more.

I’m physically inactive

Physical inactivity is another lifestyle factor linked to many cancers, including breast cancer. Getting regular exercise can also help you maintain a healthy weight. This may be particularly helpful in decreasing your risk for breast cancer after menopause.

I eat a diet high in saturated fat

Saturated fat is the kind of fat found in animal products like meat, cheese, eggs, many fried foods, and junk food. Some research has shown a link between eating a diet high in this type of fat and an increased risk of getting breast cancer. However, it’s not clear whether the risk is from the fat or the extra calories in these foods. And other research has shown that foods high in unsaturated fat, like olive oil, fish, and nuts, may actually help protect you from getting breast cancer. More research is needed. In the meantime, it can’t hurt to cut back on foods high in saturated fat, while increasing your intake of fruits and vegetables. These have been shown to protect against cancer.

I have dense breast tissue

Women whose breasts appear on mammograms to have larger areas of dense tissue compared to mammograms of women of the same age, are at increased risk for breast cancer. But people with breast cancer who have dense breast tissue do not have a higher risk of dying than those who do not have dense tissue. 

I took DES when I was pregnant

DES is a drug that was given to some pregnant women in the U.S. between about 1940 and 1971 to help prevent miscarriage. (It is no longer used.) Women who took DES during pregnancy may have a slightly increased risk for breast cancer. Women whose mothers took DES during pregnancy may also have a slightly higher risk. 

Broward Health Receives Grant to Help Women Navigate Breast Cancer Treatment

Find out more details about the Breast Cancer Navigator Program »

Broward Health provided 29,380 mammograms last year, nearly 3,000 of them for women who had no insurance and could not afford to pay. While a mammogram may be essential in detecting abnormalities, a diagnosis is meaningless without follow-up. That follow-up – particularly for poor women – can be daunting.

A grant of nearly $150,000 from the Florida Division of the American Cancer Society will help Broward Health set up a new Breast Cancer Patient Navigator Program to ensure that more women living in poverty will get the medical care they need after an abnormal mammogram or a diagnosis of breast cancer. The goal is to ensure half of the participants are African-American, Caribbean or Hispanic.

A “navigator” case manager will provide one-on-one assistance to women of any age in navigating the complexities of not only scheduling, testing and treatment, but with things like childcare, transportation, translation services and understanding medical terminology as well.

The navigator case manager will oversee the woman’s care throughout treatment at the Comprehensive Cancer Centers at Broward Health facilities (Broward Health Medical Center and Broward Health North). If the woman doesn’t show up for an appointment, stops treatment, or becomes unreachable after two weeks, the case manager will go to her home to check on her and find out why she hasn’t kept her appointments. The case manager will then work with her to get her back on track. When cancer goes into remission, the case manager will continue to monitor her health and quickly set up doctor appointments and further treatment if needed.

The navigator program is dedicated to dismantling barriers faced by medically underserved women with breast cancer, increasing access to healthcare services and ultimately improving quality of life.

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Breast Cancer Patient Navigator Program Participants

September 2006 – July 2008

The American Cancer Society awarded Broward Health the Breast Cancer Patient Navigator Program Grant in September 2006 to navigate medically underserved women of all ages (living below 200% of the Federal Poverty Level who receive an abnormal mammogram), from diagnostic mammogram to breast cancer survivorship. The two (2) year grant award provided for one (1) Registered Nurse Breast Cancer Patient Navigator to remove the barriers to care by providing one-on-one case management once breast cancer is diagnosed.

The program allows for:

  • Earlier identification/intervention
  • Greater outreach to our community
  • A broader range of services
  • Decreased treatment variability
  • Increased effectiveness of care

Evaluation Methodology

Patient Demographics

  • 282 female and 2 male patients, ages 15 thru 85
  • 57 dependent children
  • Treatment and diagnostic sites – 1-49 miles from patients' home
  • Transportation – 60% of the patients were brought to the health care site by friend or family; 34% by private car; 6% used taxi service or public transportation provided by Broward Health
Race/Ethnicity (Program)
Race/Ethnicity (Claritas 2007)
37% - Black Non Hispanic
51% - Black Non Hispanic
23% - Hispanic
18% – Hispanic
19% - White Non Hispanic
25% - White Non Hispanic
9% - Haitian
3% - Asian
7% - Other
3% - Other
2% - Asian
1% - Portuguese

Patient Participation

  • 284 - patients referred from Broward Health sites and the Broward County Health Department's Breast & Cervical Cancer Initiative
  • 109 - patients that did not meet guidelines (i.e. had insurance, were enrolled in another program, received care at another facility, refused services)
  • 63 - patients disenrolled from the program (i.e. eligibility changed, moved, changed providers, chose homeopathic treatment and/or refused treatment, treatment complete and patients are following up with primary care physician for a yearly mammogram)
  • 37 - patients in the program with no diagnosis of breast cancer that are being followed.
  • 75 - patients with diagnosis of breast cancer – majority of the cases is invasive ductal carcinoma. (61 ductal, 5 intra ductal, 4 multi focal, 3 lobular, 1 mucinous & 2 multi centric)
    1 - stage 0
    7 - stage I
    31 - stage II
    18 - stage III
    6 - stage IV
    12 - in staging process

Referral Sources

  • Broward Health hospitals and Community Health Service sites, i.e., Broward Health Medical Center, Broward Health North, Broward Health Imperial Point, and Broward Health Coral Springs.
  • Broward Health Website
  • Florida Breast Cancer Resource Network
  • Broward County Health Department through its Breast & Cervical Cancer Initiative (BCCI)
  • Other community organizations, i.e., Living Water clinics, Light of the World, churches, etc.
  • Private physician offices, friends, and family

Benefits of Program

Access & Compliance
Patients adhered to their scheduled appointments. In the event of a scheduling conflict, the Breast Cancer Patient Navigator was contacted for resolution.

Transportation and certification process has been expedited because of intervention by Breast Cancer Patient Navigator.

97% of the patients adhered to the treatment plan (3% sought alternative treatment or chose treatment elsewhere).

Care & Treatment
Recommended diagnostic procedures:

  • Mammogram
  • Spot magnification / compression
  • Ultrasound
  • Stereo tactic biopsy
  • Ultrasound biopsy
  • CT Scans, Mir's & PET Scans
  • Echocardiograms, Lab work, X-rays and ultrasounds

Recommended treatment procedures:

  • Lumpectomy
  • Mastectomy
  • Radiation
  • Chemotherapy
  • Hormonal treatment

97% of the patients adhered to scheduled diagnostic procedures

Current status of patient treatment

29 – in treatment (chemo/radiation)
30 – in post treatment
6 – refused treatment
6 – in work-up
1 – out of service area
3 – out of country

Knowledge and Education

Educational components made available to all the patients:

  • Initial education packet
  • American Cancer Society Breast Cancer Guidelines
  • National Cancer Institute Breast Cancer Booklet
  • Chemotherapy and You
  • Triple Touch
  • Nutrition
  • Knowledge & Education
  • Demand Mailings – specific topics of interest
  • Support groups and education classes
  • Look Good, Feel Better
  • Gilda's Club
  • Reach to Recovery
  • Community Church Support Group

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