Navigating Breast Health with Angela Ball, NP

Angela Ball, NP, is part of Memorial Health System’s Department of Surgical Oncology, where she specializes in supporting patients with high-risk breast conditions. She provides education, guidance, and personalized care for those navigating breast cancer risk, benign breast lesions, and overall breast health.

What does it mean to be “high risk” for breast cancer?

“Being “high risk” for breast cancer means having a significantly elevated probability of developing breast cancer compared to the general population based on clinical risk models (such as a high GAIL score), personal history, or genetic factors. Those with known pathogenic gene mutations, a history of chest radiation between the ages of 10–30, a personal history of a high-risk breast lesion, or a strong family history of breast cancer are also considered to be at high risk.

Other risk factors—like dense breast tissue, early menstruation, late menopause, or certain aspects of reproductive history—can also increase your risk.”

What is a GAIL score?

“A GAIL score is a quantitative estimate of a woman’s absolute risk of developing breast cancer over the next five years and up to the age of 90 (lifetime risk). These scores are automatically calculated whenever a mammogram is completed at Memorial Health System.”

What should a person do if their GAIL score shows a higher-than-average lifetime risk?

“They should discuss risk-reduction strategies and increased surveillance recommendations with their provider. Memorial Health System offers a High-Risk Breast Clinic located within the Department of Surgical Oncology, where a personalized preventative plan can be developed.”

What are high-risk breast lesions, and how are they typically found?

“High-risk breast lesions are abnormal changes in breast tissue that are not cancerous but are associated with a higher-than-average risk of developing breast cancer in the future. These lesions are usually found during a biopsy for another issue, such as an abnormal mammogram.”

If someone does have high-risk breast lesions, does that mean they will develop breast cancer?

“An individual with a high-risk breast lesion isn’t guaranteed to develop breast cancer—in fact, most will not—but they do have a significantly higher risk than the general population.”

What does management look like for someone diagnosed with a high-risk lesion?

“Management of high-risk breast lesions is individualized and should be based on multidisciplinary review. Surgical excision is generally recommended for some types of lesions but is normally reserved for unusual or unclear cases, while others are typically managed with imaging surveillance.

All patients with high-risk lesions should receive counseling regarding their breast cancer risk, as well as annual mammography and other risk-reducing strategies such as chemoprevention or the addition of annual MRIs, depending on their overall risk profile.”

If someone is considered high risk, what steps can they take to stay proactive about their breast health?

“Individuals who are considered high risk should speak with their healthcare provider about prevention and risk reduction. Clinical breast exams should be performed every six months, and self-breast exams monthly.

Patients should practice breast awareness and report any changes to their provider—such as new onset nipple inversion or retraction, nipple discharge, skin changes, breast pain, or axillary masses. They should also stay consistent with imaging surveillance, including annual mammograms and any additional imaging that has been recommended.”

How can people advocate for themselves if they’re concerned about their risk?

“Speak up for yourself! Do not be afraid or embarrassed to voice any breast health concerns. If you’re having symptoms or questions about your risk, visit our High-Risk Breast Clinic or call (740) 374-7985 to speak with one of our team members.”

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