High Risk Breast & Ovarian Clinic

When your mom, sister, aunt or another family member has experienced breast cancer, you understand the specialized treatment needs for women who have a family or personal history of breast cancer, or who carry a genetic predisposition to breast cancer.

The High Risk Breast Clinic at UofL James Graham Brown Cancer Center provides breast cancer screening, chemoprevention, and genetic risk evaluation for individuals at increased risk of breast cancer due to a personal or family history of cancer, or the identification of a genetic mutation such as BRCA1 or BRCA2.

Our multidisciplinary team is comprised of specially-trained genetic counselors and physicians who work together to provide education, hereditary cancer risk assessment, genetic counseling and testing, individualized cancer screening, and prevention programs to people who are concerned about their risk for breast cancer.

To learn more about the High Risk Breast Clinic, call 502-562-HOPE (4673).

High Risk Breast & Ovarian ClinicAt the UofL James Graham Brown Cancer Center’s High Risk Breast and Ovarian Cancer Clinic, our team of providers work with you to provide the best care to each individual patient. We recognize that each patient has different needs, concerns, goals, and plans that must be addressed individually. Our team of medical oncologists, breast surgeons, plastic surgeons, gynecologic oncologists, genetic counselors and dietitians collaborate with patients to provide a personalized approach to her care.  

Medical Oncologist: Counseling, screening, and medical intervention options will be discussed with a medical oncologist to determine the best timing or need for interventions. 

The medical oncologist affiliated with the High Risk Breast and Ovarian Cancer Clinic is Dr. Mounika Mandadi. Dr. Mandadi has a specific interest and expertise in the treatment of breast cancer and the care of women who have a high risk of breast cancer. In addition, she is actively involved in research to find new and innovative treatments for early diagnosis and treatment of breast cancer, with the goal to reduce the number of breast cancer deaths in the region and worldwide.

Genetic Counselor: Patients who have a strong family history or known genetic mutation which increases the risk of breast and ovarian cancers meet with a genetic counselor to discuss genetic testing and results.  

Surgeons: Breast surgeons and plastics surgeons counsel patients on surgical options for risk reduction and reconstruction.  Personalization often leads to better outcomes and reduced complications.

The breast surgeon affiliated with the High Risk Breast and Ovarian Cancer Clinic is Dr. Nicolas Ajkay.  Dr. Ajkay has specialty training in breast surgery with a specific interest in risk-reducing surgery.  

The plastic surgeons affiliated with the High Risk Breast and Ovarian Cancer Clinic are Dr. Terry McCurry and Dr. Bradon J. Wilhelmi.  They have a specific interest in breast reconstruction for patients with high risk for breast cancer.  

Gynecologic Oncologists: Gynecologic oncologists provide personalized care for patients who also have an increased risk of ovarian or gynecologic cancers. Counseling, screening, and surgical risk-reduction will be discussed during consultation. Personalized approaches to surgical risk-reduction as well as screening help patients achieve reproductive goals while maintaining appropriate surveillance. Sexual health, routine gynecologic care, and reproductive plans can be effectively managed.

Dietitian: Dietitians discuss lifestyle choices that have been shown to reduce the risk of developing breast cancer. They also help develop a plan for weight management and answer questions about nutrition. 
 

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Mounika Mandadi, MD
Mounika Mandadi, MD
Type of Doctor
Medical Oncologist
Area of Interest
Internal Medicine, Hematology/Oncology
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Nicolas Ajkay, MD
Nicolas Ajkay, MD
Type of Doctor
Surgical Oncologist
Area of Interest
Breast cancer, diseases of the breast, inflammatory breast cancer, breast cancer in young women, skin-sparing mastectomy, nipple-sparing mastectomy, axillary dissection, sentinel lymph node biopsy, lumpectomy, vascular access for chemotherapy, high risk evaluation, breast cancer research and clinical trials, intraoperative radiation therapy
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Terry M. McCurry, Jr., MD
Terry M. McCurry, Jr., MD
Type of Doctor
Plastic Surgeon
Area of Interest
Head and Neck Melanoma, Breast Reconstruction, Body Contouring (Including Patients Who Have Had Weight Loss Surgery) and Breast Surgery (Reconstruction, Reduction, Augmentation and Corrective or Revision of Previous Breast Surgery)
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Bradon J. Wilhelmi, MD
Bradon J. Wilhelmi, MD
Type of Doctor
Plastic Surgeon
Area of Interest
Facelifts and Other Aesthetic Plastic Surgery, Breast Augmentation, Reduction and Reconstruction, Body Contouring and Hand and Wrist Reconstructive Microsurgery
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Our physicians work both in the treatment of breast and ovarian cancer patients, and also are dedicated to understanding new and innovative treatments and strategies for early detection and prevention. One of the missions of the High Risk Breast and Ovarian Cancer Clinic is to better understand how multidisciplinary care of breast and ovarian cancer patients may improve outcomes and quality of life among high risk patients. This clinic aims to increase specific research to this patient population as well as give patients an opportunity to contribute to such research through the donation of blood and tissue.

To be considered for the High Risk Breast and Ovarian Clinic at UofL Brown Cancer Center, the patient should fit the criteria listed below. To refer a patient, call 502-562-HOPE (4673).

  • Have a family history of: 
    • Two or more relatives on the same side of the family with breast cancer, especially at young age (<50 years)
    • First or second degree relatives with breast cancer at age < 45 years
    • Ovarian cancer
    • Male breast cancer
    • BRCA 1 and BRCA 2 mutations
    • Other conditions with increased risk of breast cancer – Cowden syndrome, Li-Fraumeni syndrome
  • ​​​​​Individuals who had a prior breast biopsy that showed Atypical ductal hyperplasia, Lobular carcinoma in situ, Ductal carcinoma in situ 
  • History of prior chest wall radiation for lymphoma
  • Any woman who has had:
    • High grade ovarian, fallopian tube, or peritoneal cancer
    • Breast cancer <45 years
    • Breast cancer <50 years with a limited family history
    • Breast cancer with >/= 2 close relatives with breast cancer at any age
    • Breast cancer with >/= 2 close relatives with pancreatic cancer or aggressive prostate cancer
    • Two breast primaries, with the first diagnosed prior to age 50
    • Breast cancer and Ashkenazi Jewish ancestry
    • Pancreatic cancer with >/= 2 close relatives with breast, ovarian, fallopian tube, peritoneal, pancreatic, or aggressive prostate cancer