Main Line Health's Breast Health Partnership, under the medical direction of Thomas Frazier, MD, provides comprehensive breast cancer services across the hospitals of Main Line Health (Bryn Mawr, Lankenau and Paoli).

The primary goal of the Breast Health Partnership is to establish standardized practice activities among medical and nursing providers in the areas of early detection, diagnosis, treatment, pathology and follow-up care. Through research and participation in clinical trials, we are on the forefront of the latest medical technology in the treatment of breast cancer.

Breast Cancer Risk Assessments
This program is for any woman who would like to assess her lifetime risk for developing breast cancer. Women who have a strong family history of breast cancer will receive genetic counseling and genetic testing if appopriate. This assessment is accomplished through:

• Completion of a survey screening tool reviewed by a nurse, genetic counselor and a medical oncologist
• Initial consultation with a registered nurse
• Consultation with a team of risk assesssment professionals
• Genetic testing for women meeting the eligibility requirements
• Evaluation and follow-up consultation

To learn more about this program, contact Nancy Shields, RN, at 610-645-8150.

Breast Health Screenings
There are many screening tools available to detect breast cancer, but the easiest is the breast self-exam. Doing monthly breast self-exams may provide early detection of lumps in the breast. If you are unsure of how to do a breast self-exam, contact our Women's Health Source resource center at 1-888-876-8764 to learn the easy techniques.

Consult our Event Calendar to see about any upcoming breast health screenings or call 1-866-CALL-MLH.

Is The STAR Trial Right for You?
Breast cancer is the most common type of cancer in North American women. One in nine women will develop breast cancer in their lifetime. To help reduce the incidence of breast cancer in women, a national study, the STAR trial, is currently underway. This study is designed to determine how the drug raloxifene (Evista) compares with the drug tamoxifen (Nolvadex) in reducing the incidence of breast cancer in women who are at increased risk of developing the disease. This study is being conducted at 400 centers across the United States, Puerto Rico, and Canada by researchers at the National Surgical Adjuvant Breast and Bowel Project (NSABP). Lankenau, Bryn Mawr and Paoli Memorial Hospitals are pleased to be among the participating centers for the STAR trial.

Tamoxifen has been used for more than 20 years to treat patients with breast cancer. Tamoxifen works against breast cancer, in part, by interfering with the activity of estrogen, a female hormone that promotes the growth of breast cancer cells. As a result of the Breast Cancer Prevention Trial, the U.S. Food and Drug Administration (FDA) approved the use of tamoxifen to reduce breast cancer risk or incidence in women at high risk of developing the disease. This approval took place in October 1998.

Raloxifene was approved by the FDA in December 1997 for the prevention of osteoporosis in postmenopausal women. Raloxifene is being reviewed because large studies testing the effectiveness against osteoporosis have shown that fewer women taking the drug developed breast cancer than women taking the placebo.

Women eligible to participate in the STAR Trial are those who are at increased risk to develop breast cancer and who have gone through menopause, either natural or surgical, and are at least 35 years old. All participants must have an increased risk of breast cancer equivalent to or greater than that of an average 60 to 64 year-old woman.

Premenopausal women are excluded from this study because currently raloxifene has not been adquately tested for long-term safety in premenopausal women.

The following are risk factors used to determine an increased chance for breast cancer:

• Current age
• Number of first degree relatives diagnosed with breast cancer
• Age of first live birth
• Number of breast biopsies a women has had, particularly those that were atypical hyperplasia
• Age of first menstrual period
• Women diagnosed with lobular carcinoma insitu (LCIS).

To learn more about the STAR Trial or other current breast health clinical trials, call one of the STAR Hotlines listed below. A clinical research nurse will address your questions and provide appopriate guidelines.

• Bryn Mawr Hospital: 610-526-3428
• Lankenau Hospital: 610-645-6475
• Paoli Hospital: 610-648-1621