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Research Shows Genetic Approaches to Breast Cancer Screenings Yield More Accurate Results
Clinical researchers with the Healthy Nevada Project co-author research paper with findings that emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. Breast cancer is a leading cause of cancer death among women in the United States. According to the American Cancer Society, about 1 in 8 women will develop breast cancer and about 1 in 39 women will die from breast cancer. Breast cancer is associated with increased age, hereditary factors, obesity, and alcohol use. Since 1990, breast cancer death rates have declined progressively due to advancements in treatment and detection. In Nevada there are an estimated 2,310 new breast cancer cases a year, and genetic mutations such as in the genes BRCA1 or BRCA2 remain a top risk factor for this prevalent disease. Recognizing the urgency for progress in breast cancer research, a collaborative effort between physicians, advanced practice providers and scientists from the Healthy Nevada Project® (HNP) and Helix have unveiled groundbreaking research. This study explores how genetic screenings are a necessary supplement to traditional testing methods, together offering more accurate insights into a patient's likelihood of developing breast cancer in the future. HNP is operated by Renown Genomic Medicine and the Institute for Health Innovation and is one of the largest community-based population health studies in the country. Their team works in collaboration with Helix, a leader in precision health that delivers comprehensive genomic solutions. Together, this dynamic partnership aims to understand breast cancer risk factors and pave the way for more effective preventative measures. The combined research team studied 25,591 female HNP participants to evaluate the performance of different genetic screening approaches to identify women at high risk of breast cancer. The results of this research suggest that a combined monogenic, or single-gene, and polygenic, or multi-gene, approach to breast cancer screenings helped produce more accurate results and more closely identify study participants who have a high genetic risk of developing the disease. "Based on this research, we are advocating a shift in approach which would improve breast cancer risk assessment through a combination of effective family history ascertainment and genetic screening,” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project, research professor at the University of Nevada, Reno School of Medicine and co-author of the breast cancer research paper. “This tailored approach, founded on the assessment of individual genetic risk, not only intends to elevate patient well-being but also will improve efficiency and equity in healthcare." Complementing the team’s research on leveraging genetics to identify women at low genetic risk of breast cancer that could safely defer mammogram screenings by five to 10 years that was released in late 2023 in JAMA Oncology, the study suggests that incorporating genetic information can assist in personalizing breast cancer screenings and optimizing the use of screening resources. "Existing disparities persist across various facets of breast cancer screening and treatment; however, genetic screening is clearly a powerful tool to help facilitate early intervention for those at higher risk,” said Jamie Schnell Blitstein, APRN, a primary care nurse practitioner at Renown Health and co-author of the breast cancer research paper. “By placing a heightened focus on risk, we underscore the pivotal role of preventative breast cancer screening.” Despite the availability of effective methods for early screening, co-authors of this research found that 78 percent of women with a family history of breast cancer had their risk ascertained only after a breast cancer diagnosis. The findings emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. “These findings that can profoundly impact how healthcare is delivered were only made possible by all the participants who were willing to consent to research,” said Alex Bolze, PhD from Helix and co-author of the publication. “Broad-scale collaboration projects like these between Renown Health and UNR that engage large populations where participants share both their genetic information as well as electronic health records drive advancements in preventative medicine, as well as fundamental biological research.” The research paper was officially accepted on Jan. 29, 2024, and will be published by Elsevier, Inc. on behalf of the American College of Medical Genetics and Genomics. The contents of the paper will appear in the international journal Genetics in Medicine Open. Read the full article by visiting sciencedirect.com. The Healthy Nevada Project is currently recruiting new study participants. Free to all Nevadans with a saliva sample or blood draw, participants and their referring providers receive access to whole-exome sequencing and clinical grade results that help provide insight into their unique genetic risks tied to heart disease and certain cancers. If you are interested in enrolling in the study, schedule a Virtual Consent Appointment through MyChart or contact the Renown Institute for Health Innovation at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About Renown Health Renown Health is the region’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the largest community-based genetic population health study, the Healthy Nevada Project®. To join the Renown Health team, visit renown.org/careers. About Helix Helix is the leading population genomics and viral surveillance company operating at the intersection of clinical care, research, and data analytics. Helix enables health systems, life sciences companies, payers, and government partners to accelerate the integration of genomic data into patient care and public health decision-making. Learn more at helix.com.
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A Friend to Veterans, A Friend to Renown
Did you know that 218,000 veterans and their families call Nevada home? That is almost 7% of our total population who served this country and will require quality access to healthcare at some point in their lifetime. When faced with a daunting diagnosis or procedure, such as cancer or surgery, Renown rises to the occasion to provide veterans and their loved ones with the highest caliber of care possible to protect the lives that protected ours. Accessing that care, however, can be a challenge for some. As Renown serves veterans across 100,000 square miles, veterans living in rural communities often must travel long distances – with the costs of overnight lodging standing in the way, making healthcare access out-of-budget, and sometimes, nearly impossible. That’s where Veterans Guest House comes in. Veterans Guest House provides veterans and their families with temporary overnight accommodations while receiving medical treatment in the Reno/Sparks area. Founded in 1993 in response to the growing number of veterans sleeping in their cars to access healthcare, the nonprofit embraces veterans and their families who would otherwise not be able to obtain the medical care they need because of inabilities to pay for overnight lodging. A support system for veterans, especially veterans who are senior citizens, is vital to their overall health and well-being – and seniors at Veterans Guest House never have to feel alone in their care journey. Enter Dyana Parks, a senior care assistant working with Veterans Guest House. A friend to Renown Health and the William N. Pennington Cancer Institute, Dyana goes the extra mile for seniors staying at Veterans Guest House – she not only helps them navigate the logistics of their care, but she also is one of their biggest mental well-being champions. A Helping Hand for Guests in Need A proud member of a veteran family herself, senior and veteran in-home care is a family affair for Dyana. With a sister experiencing post-accident brain damage, elderly parents – one of whom facing dementia – and a son and daughter-in-law in the same field of work, Dyana has a unique passion for in-home and dementia care and holds several decades of hospice experience. As such, when she was assigned to help the clients at Veterans Guest House in September 2022, it was a natural fit for her, and she immediately jumped into action. Dyana takes special time during her work hours to transport seniors in need to their appointments at Renown (and keeps track of all of them), sits with them through chemotherapy and radiation treatments, ensures patients stay hydrated and nourished after major procedures, picks them up from surgery and always ensures everything goes well with each patient’s care. When patients coming from Veterans Guest House need extra emotional support, Dyana is always there to make sure they are okay and push them to keep going. “I always say to my seniors, ‘never give up,’” said Dyana. “If a need arises, I am there to help. I love getting to know my clients and helping them go home healthy.” As a ‘frequent flier’ at Renown and the William N. Pennington Cancer Institute, many of our team members are thrilled when they see Dyana walking through the doors with her clients, as they know that their patient is going home with one of their strongest advocates. To Dyana, Renown is akin to a family for both herself and her clients. “I love Renown,” said Dyana. “Everyone there makes my clients feel as though they are more than just a patient – they make them feel like family, especially when going through a scary diagnosis like cancer. As someone who has been going there with my own family forever and who now guides veteran seniors through the process, I will always recommend Renown to anyone.” Dyana emulates exactly what it means to make a genuine difference in the health and well-being of our community, all while raising awareness for both Renown and Veterans Guest House. “More people need to know about Veterans Guest House,” said Dyana. “When I came here, I was in awe. They do so much for every guest, making them feel comfortable at home while not having to worry about finances. Almost everyone that comes here, whether it be from the rural surrounding towns or all the way out to Alaska and even the Philippines, needs treatment of some kind, and I know Renown will always give them the best care.” To learn more about Veterans Guest House, visit veteransguesthouse.org.
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Optimizing Mammogram Screenings: A Genetic Approach to a Personalized Screening Schedule
Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.