Breast and Cervical Cancer

Breast cancer is the second leading cause of cancer deaths for women in the United States and in Georgia. Early detection is critical; cancers found earlier are more likely to be treated successfully, and women are surviving longer with breast cancer. Through prevention initiatives such as early detection of pre-cancerous abnormalities and HPV vaccination, cases of cervical cancer have dramatically fallen in Georgia.

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To help reduce the impact of breast and cervical cancer in Georgia, the Georgia Department of Public Health provides breast and cervical cancer screening, diagnostic services and referral to treatment as medically indicated to uninsured and underinsured women residing in Georgia..

Eligibility

Uninsured or underinsured Georgia residents under 200 percent of the federal poverty level may be eligible. Cervical cancer screening is available to women 21 to 64 and breast cancer screening is available to women between the ages of 40 and 64. Individuals under 18 may also be eligible for free or low-cost HPV vaccination. To find out if you are eligible and to access services, please call your local county public health department . For more information about BCCP, contact [email protected].

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High-Risk Breast Cancer Indicators

Individuals with any of the following are at high risk for breast cancer:

Past personal history of breast cancer;
Family history of breast cancer in a parent, sibling, or child;
Genetic testing positive for BRCA 1 or BRCA 2 gene mutation or other high-penetrance breast and or ovarian susceptibility genes;
Genetic testing not completed, but has a close (first, second or third-degree) biological relative with a BRCA 1 or BRCA 2 gene mutation or other high-penetrance breast and or ovarian cancer susceptibility genes;
Radiation therapy to the chest between ten and 30 years of age; or
Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley Ruvalcaba syndrome or has a first-degree relative who has any such syndrome.

Individuals identified as high risk for breast cancer by having one or more of the above risk factors should:

Discuss with their healthcare provider to determine the appropriate course of follow-up;
Request access to genetics provider for further education, testing, and guidance;
Request assistance from the GA Breast and Cervical Cancer program if they are uninsured and need assistance accessing genetics or other services.

Guidance for providers for identification and follow-up of the above risk factors:

Screen Screening tools to identify high-risk individuals:
https://www.georgiacancerinfo.org/breast-cancer-gene-screen
https://brcagenescreen.org/
If an individual is identified as being at high risk, they should be referred for genetic counseling, including education and counseling, in accordance with recommendations of the United States Preventive Services Task Force (USPSTF):
If a mutation is confirmed there may be alternate mammogram recommendations and indications for MRI depending on the mutation identified.
Guidelines from the following can be used to determine the best management strategies:
- National Comprehensive Cancer Network: https://www.nccn.org/
- American Society of Clinical Oncology: https://www.asco.org/
- American College of Obstetrics and Gynecology: https://www.acog.org/
- American Association of Family Physicians: https://www.aafp.org/home.html
Determine best options based on individual situation and preferences: heightened surveillance, chemoprevention or risk-reduction therapies.

Services

Services provided by the Georgia Breast and Cervical Cancer Program (BCCP) include:

Clinical Breast Examination
Mammogram
Pelvic Examination
Pap test
Human papillomavirus (HPV) test
Diagnostic testing of abnormal results
Referrals to treatment through the Women’s Health Medicaid Program

Follow-Up Services

Women diagnosed with breast or cervical cancer through the program, or referred to the program by a physician, may be eligible for treatment through Medicaid coverage as authorized by the Breast and Cervical Cancer Treatment and Prevention Act passed by Congress in 2000.

Georgia Breast Cancer Genomics Project

The Georgia Department of Public Health has partnered with the Georgia Center for Oncology Research and Education (CORE) to provide a free online screening tool to assess hereditary risk for breast and cervical cancer. This tool is designed to quickly identify who should be referred for screenings and genetic counseling and is available to women of all ages in the state of Georgia.

Hereditary Breast and Ovarian Cancer syndrome (HBOC) is an inherited tendency to develop breast, ovarian, and other cancers, and at a younger age. The majority of HBOC is due to a mutation in the two most common breast cancer genes (BRCA1 or BRCA2 genes).

Women with an inherited mutation have up to a sixty-five percent lifetime risk of developing breast cancer and up to forty-four percent chance of developing ovarian cancer. It is estimated that with appropriate screening in Georgia, hundreds of potential BRCA related breast and ovarian cancers can be prevented.

All women should have a mammogram as appropriate for their age. To determine whether you may benefit from BRCA testing complete the Breast Cancer Genetics Referral Screening Tool (B-RSTTM) located at www.breastcancergenescreen.org. Providers are also encouraged to have their patients complete this tool.

If a positive screening result is identified, start by contacting your local county health department or other provider(s) near you that offer screening. If you have additional questions about the genomics testing program, contact 404-584-1178.