Making Rounds
The new High-Risk Breast Clinic dials in patient screening for better outcomes
When Hunter Hutson started work at Cape Fear Valley Health’s new High-Risk Breast Clinic in September 2023, it was thanks to true serendipity. A native of Texas, Hutson had planned to seek work there after graduating from the Physician Assistant program of the University of Mary Hardin at Baylor. But after falling in love with a serviceman who wound up stationed at Fort Liberty, she suddenly had to find a job in a place where she knew no one.
Luckily, a colleague who had spent 30 years working at Cape Fear Valley before moving to Texas heard of her plight and put her in touch with the hospital. Hutson’s number-one choice of job was to work in a high-risk breast clinic — and Cape Fear Valley was on the verge of opening one. “The timing worked out perfectly,” Hutson said, adding she’s thrilled to be working with the rest of the team and helping so many women. The High-Risk Breast Clinic is the first of its kind in the Sandhills region. It offers enhanced screening for patients who are at greater risk of developing breast cancer. Typically, one in eight women will develop breast cancer during her lifetime, but a high-risk patient has a one in five chance or higher.
“Screening is the name of the game,” Hutson says. “I can’t ever prevent breast cancer 100 percent, but I can do a lot to try and catch it early, and earlier treatment ends up significantly better for outcomes.”
Patients are typically referred to the High-Risk Breast Clinic by their primary care provider or OB/GYN, who may have noted an irregularity in a standard screening or biopsy. Hutson starts off her assessment with a computer tool that takes into account factors such as the patient’s health history, menstrual cycles or menopause age, family history and previous biopsies. Depending on the results, she recommends various options for next steps.
“If a patient is found to be high risk, I begin managing their mammograms. If they’re less than 40 years old, we discuss starting mammograms early,” Hutson says. “We also implement breast MRIs, so I have eyes on their breasts at two different points of the year to catch anything that comes up very early.” Patients with certain family histories of breast cancer may also be offered genetic screening when appropriate.
Another option for some high-risk patients is endocrine therapy. This is a type of hormone-blocking treatment that prevents estrogen and progesterone from creating breast cancer.
“The majority of breast cancer grows under the influence of female hormones, and this pill blocks that from happening and reduces risk quite a bit,” Hutson said. She can provide a referral for potential candidates for the therapy to the oncology team at Cape Fear Valley’s Breast Care Center. If screening detects an irregularity or malignancy, the High- Risk Breast Clinic provides a seamless transition for patients referred for additional treatment at the Breast Care Center.
“I think that a lot of women get ignored when they’re concerned about breast cancer and their family history ... I love to listen to them and do everything we need to do to make sure that they’re getting the proper care that they need.”
“There’s no lapse in treatment time,” Hutson said.
Many of the staff of the High-Risk Breast Clinic are also on the breast cancer treatment teams, so patients will encounter familiar faces. Hutson adds that nowadays, the options for breast cancer treatment are numerous. No matter a patient’s risk status, Hutson emphasizes the importance of knowing family history of breast cancer.
“I cannot stress enough how important it is to have that information,” she said. “It can drastically change the risk assessment.”
She notes that even if a patient has a single relative who had breast cancer, such as an aunt, knowing that information is critical. “It’s so very important to share that information in families,” she adds. “I know it’s very sensitive and emotional, but I can’t stress enough how beneficial it is.”
A referral to the High-Risk Breast Clinic may make some patients nervous, but Hutson wants them to know that she and her team will do everything they can to ease those anxieties.
“We take them seriously,” Hutson said. “I think that a lot of women get ignored when they’re concerned about breast cancer, concerned about their family history — I see that a lot of them don’t get listened to. I want them to know that I love to listen to them and take them seriously and do everything that we need to do to make sure that they’re getting the proper care that they need.
