Prevention

Breast and ovarian cancer prevention

The Breast and Ovarian Cancer Prevention (BOCP) Clinic at Seattle Cancer Care Alliance (SCCA) is for people with a higher risk for breast cancer and/or gynecological cancers. We help patients reduce risk by making personalized prevention and early detection surveillance plans for them.

Before coming to us, patients often have genetic testing done. Then, if a genetic risk is identified, they will come to the BOCP Clinic. Or, if they have a higher risk due to significant family history of breast cancer, they will go to our Breast Health Clinic. Sometimes this pathway can change, depending on the patient.

Not sure where you should be seen? We can help. It’s our job at SCCA to find the best care for you. If you have questions, call us at (206) 606-6100.

The BOCP clinic is located at SCCA Wellness Center. Get a map, directions and other details about this location.

Breast and Ovarian Cancer Prevention Clinic

phone (206) 606-6100
Hours: Monday to Friday, 8 am–5 pm
fax (206) 606-6142

Telehealth appointments available

We also offer telehealth (online) appointments that you can access conveniently from anywhere using your computer, smartphone or any Internet-connected mobile device. To ask if a telehealth video visit is right for you, call us at (855) 557-0555.

What happens at your first appointment

Before your visit to the Breast and Ovarian Cancer Prevention Clinic at SCCA, our experts will review your medical records, your family history of cancers and the results of any tests you may have completed elsewhere. We will also send you some questions, which you will need to answer and return to us before you schedule your first appointment.

Once we have this information, we will schedule a time to discuss your results and work with you to build your personalized prevention and early detection surveillance plan. The goal is to reduce your risk of developing cancer and to find cancer early when it can be more easily treated, if it does occur. 

During this appointment, and depending on your unique risk profile, you may meet with one or more providers, such as a medical oncologist, breast health physician, gynecologic oncologist, genetic counselor or registered dietitian. The length of the visit depends on how many appointments you have, but it is usually about two hours.

Your plan will be as unique as you are. We partner closely with SCCA’s Clinical Genetics and Counseling Service. We may recommend that you get screened at an SCCA surveillance clinic. This may include visits to SCCA Wellness Clinic for routine exams and close monitoring or visits to the SCCA High Risk Surveillance Clinic. In some cases, your prevention plan can be managed by the provider who referred you to us or your primary care provider.

What is included in my personalized prevention plan?
  • Information about hereditary (passed down in your family) and nonhereditary breast or gynecological cancer risk factors 
  • Ways to lower your breast or gynecological cancer risk
  • Information about clinical trials you are eligible to be part of through SCCA and our partners at Fred Hutchinson Cancer Research Center and the University of Washington Medical Center 
  • A letter with a detailed summary of your visit
What are some of the strategies that may be used to reduce my risk?

Your BOCP multidisciplinary team will work with you to customize a plan that may include:

  • Blood tests
  • Chemoprevention or medication
  • Imaging, like mammograms, ultrasounds or magnetic resonance imaging (MRI)
  • Lifestyle changes, such as changes in diet and exercise
  • Participating in clinical trials, if you choose
  • Risk-reducing surgery
  • Screening with physical exams
“Finding out that you are at risk for ovarian cancer can lead to significant worry. In this clinic, we give our patients the tools to help them manage their risk. They are not in this alone, and we will use our knowledge to build a plan that is right for them.”
— Barb Norquist, MD, Medical Director, Breast and Ovarian Cancer Prevention Clinic

Frequently Asked Questions (FAQs)

What does “a strong family history of breast or ovarian cancer” and “high risk” mean?

Family history and genetic testing both provide important clues about your risk level. You may be at high risk of developing breast or gynecological cancer if:

  • You had an abnormal result on your genetic test, such as testing positive for a BRCA1 or BRCA2 pathogenic variant
  • You have Lynch syndrome or another genetic abnormality linked with breast cancer, ovarian cancer or uterine cancer
  • Two or more relatives on the same side of your family have had breast or ovarian cancer, especially if the breast cancer was diagnosed before age 40
  • A relative had cancer in both breasts
  • A relative had both breast and ovarian cancer
  • Male relatives have had breast cancer
What is genetic counseling?

Genetic counseling is the process of providing education and emotional support to patients about inherited conditions and how they impact a person and their family. The goal of genetic counseling is to provide clear, useful information about genetic risk factors in a way that helps you learn more and make decisions about cancer treatment, prevention or early detection.

Why is prevention especially important for people with a genetic risk towards breast or ovarian cancer?

If you have a genetic risk for a breast or gynecological cancer, more frequent screening and surveillance will allow your physicians and care providers to find any abnormalities in their early stages, when they can be more easily treated. And, for some patients at risk of breast or gynecological cancer, risk reduction surgery can reduce their risk by a lot. 

If you do develop a type of breast or ovarian cancer, knowing your genetic test results can lead to more effective, precise treatments, which can mean better outcomes for you.

Care team

Our integrated approach to breast and ovarian cancer prevention brings together experts from a variety of specialties within Seattle Cancer Care Alliance (SCCA).

Advanced practice provider

These health care professionals work closely with your physician. There are two types: physician assistants (PAs) and advanced registered nurse practitioners (ARNPs). They help provide and coordinate your treatment and can see you without your physician. They also help manage any effects of your disease and treatment.

Breast health specialist

If a physician discovers an abnormality in a patient’s breast, they may refer them to a physician known as a breast health specialist. The breast health specialist will do more tests to find out whether the abnormality is cancerous or noncancerous. A breast health specialist may also work in breast cancer prevention and develop plans for reducing risk.

Breast medical oncologist

If a patient is diagnosed with breast cancer, they may be seen by a breast medical oncologist. This specialist will decide what types of medicine-based treatments might help the patient, such as chemotherapy or endocrine therapy to treat a hormone-related cancer. Medical oncologists can also prescribe medicine to help prevent cancer from spreading, slow its growth and reduce symptoms related to cancer.

Genetic counselor

This specially trained health care provider helps you understand your risk of a genetic disorder. A genetic counselor can also determine if genetic testing could be helpful for you, based on your personal and family medical and health history. After you have had genetic testing, a genetic counselor can offer information and resources for prevention; connect you with prevention programs, such as those available at SCCA; and help with testing your family members, based on your results. SCCA Genetic Counseling Service providers are all licensed, board-certified genetic counselors.

Gynecologic oncologist

If a patient is diagnosed with a gynecologic cancer, is suspected to have a gynecologic cancer or is at higher risk of gynecologic cancer, they may be seen by a gynecologic oncologist. Gynecologic oncologists provide complete surgical and medical care, including chemotherapy if needed. Some examples of conditions treated by gynecologic oncologists are ovarian cancer, endometrial cancer, cervical cancer, vulvar cancer, advanced gynecologic surgery and inherited risk of cancer.

Patient care coordinator

The patient care coordinator will likely be one of the first people you meet when you come to SCCA. They will gather your medical records and family health history and help guide you to the appropriate genetics or prevention care services within SCCA.

Registered dietitian

Registered dietitians are credentialed food and nutrition experts. To earn this title, they must go through a lot of training and formal education, including doing an internship and passing a national registration exam. Registered dietitians provide medical nutrition therapy, which means they use an evidence-based approach to treat and help patients manage medical conditions through diet and nutrition.

Registered nurse

Your nurse manages your care alongside your physician. They also assist with procedures and treatments. Nurses are resources for you and your caregiver. They answer questions and help with a wide range of topics, like how to cope with side effects or get other services you need at SCCA.

Social worker

SCCA social workers are professionals who are trained to offer support to patients who have received a cancer diagnosis, are going through cancer treatment or are in recovery. They also work with people who are at high risk for cancer. Oncology social workers are key team members who have the knowledge and resources to help connect you with the right resources, such as psychiatry and psychology services, to support you through preventive care or treatment.

Find care team profiles

Meet the caring, dedicated people who take care of you and your family at SCCA.

Denise L. Bundow, ARNP
Denise L. Bundow, ARNP
Advanced Registered Nurse Practitioner
Advanced Practice Provider
Ellen  Chuang, MD
Ellen Chuang, MD
Physician
Medical Oncology
Natasha B. Hunter, MD
Natasha B. Hunter, MD
Physician
Medical Oncology
Barbara Stulken Norquist, MD
Barbara Stulken Norquist, MD
Physician
Gynecologic Oncology
Katy  Pennington, MD
Katy Pennington, MD
Physician
Gynecologic Oncology
Elizabeth M. Swisher, MD
Elizabeth M. Swisher, MD
Physician
Gynecologic Oncology
Rachel L. Yung, MD
Rachel L. Yung, MD
Physician
Medical Oncology

Supportive care services

Raymond Palko, MS, RD, CSO, CD
Raymond Palko, MS, RD, CSO, CD

Raymond Palko is a registered dietitian who works with patients who are at high risk of developing breast or ovarian cancer. He also works with patients with breast, renal and endocrine cancers and melanoma, as well as supporting them after treatment. Raymond sees patients at SCCA South Lake Union and SCCA Issaquah. Raymond is a board-certified specialist in oncology nutrition.

Cynthia Handford, MSc, CGC, CCGC
Cynthia Handford, MSc, CGC, CCGC

Cynthia Handford has been a genetic counselor since 2007 and has worked in both clinical and laboratory settings. She has a special interest in hereditary cancer and enjoys helping patients and their families use genetic information to be proactive with their health. Cynthia is certified by the American Board of Genetic Counseling as well as the Canadian Association of Genetic Counselors and licensed by the Washington State Department of Health.