When Stephanie McLaurin was confronted with the likelihood that cancer could be in her future, she took matters into her own hands to reduce her risk.
“I was told that you are considered at high risk for breast cancer if your mother was diagnosed with it,” Stephanie said. “My mom had a lumpectomy at age 32 and had two more suspicious lumps removed after that.”
With that knowledge, Stephanie, 46, who grew up in Hope Mills, began mammograms at 32, earlier than the average age of 40 recommended by the Mayo Clinic.
After some other health issues in 2021 and due to her cancer risk, she was referred to the Cape Fear Valley Cancer Center where she heard about Dr. Elizabeth Sawyer, a breast oncology surgeon and the medical director of the Breast Care Center at Cape Fear Valley Health and the new High Risk Breast Clinic.
Dr. Sawyer introduced Stephanie to Hunter Hutson, the manager of the High Risk Breast Clinic and a physician assistant, who immediately outlined Stephanie’s options based on her family history and a monitoring plan for annual screenings.
“Besides regular breast exams, Hunter has created a plan to keep a close eye on me,” Stephanie said. “Her treatment plan has given me an alternative to taking medication or having surgery.”
Given her family’s cancer history — her father suffered from both kidney and brain cancer — Stephanie began alternating MRIs with her annual mammograms, reviewing the results each time with Hunter.
“My mom’s [breast] cancer could not be seen on a mammogram and thankfully it was caught early by an MRI,” Stephanie said.
Stephanie says she is grateful to have been led to the clinic and have the option to be consistently monitored and not need medication or major surgery.
“Early detection is so important and I’m thankful I’m in great hands,” Stephanie said.
Hunter said that patients like Stephanie are exactly why the new high-risk breast cancer clinic was established.
“It addresses a critical need in our community,” Hunter said. “With advancements in genetic testing and risk assessment, more women are becoming aware of their increased risk of breast cancer due to factors such as family history, genetic mutations, or personal health history.”
The specialized center is dedicated to providing comprehensive care and support tailored to the unique needs of high-risk individuals.
“Our center aims to offer a multidisciplinary approach that combines the expertise of breast oncology surgeons, radiologists, genetic counselors, and other health care professionals,” Hunter said.
The center provides personalized risk assessment, genetic testing, screening, surveillance, and risk-reduction strategies to empower women with knowledge and proactive management options.
“By centralizing high-risk breast care services, we streamline access to specialized care, facilitate early detection, and ultimately improve outcomes for women at increased risk of breast cancer,” Hunter said.
Although not all breast changes are an indication of cancer, there are warning signs, Hunter said. They include:
A lump or mass in the breast or underarm area
Changes in the size, shape, or appearance of the breast
Skin changes such as redness, dimpling, or puckering
Nipple changes, including inversion, discharge, or scaling
Persistent breast or nipple pain
“Any concerning symptoms should be promptly evaluated by a health care professional,” Hunter said. “And any family history can increase the risk of developing breast cancer.”
In Stephanie’s case, she had a first-degree relative, defined as a parent, sibling, or child, which put her at higher risk. Other risks include having multiple family members with breast or ovarian cancer, especially at a young age, which further elevates the risk.
“However, it’s essential to remember that having a family history doesn’t guarantee someone will develop breast cancer, and conversely, many women with breast cancer have no family history of the disease,” Hunter said.
She suggests women, whether high risk or not, include at-home breast exams as a part of a regular routine to become familiar with the normal look and feel of their breasts.
“While they may detect some lumps or changes, they are not foolproof for detecting all breast cancers,” Hunter said, while adding that research suggests that clinical breast exams, performed by a medical provider, and mammograms are more effective in detecting breast cancer.
“Annual mammograms are recommended for women starting at age 40, or earlier for those with a family history of breast cancer or other risk factors,” he said. “Mammograms are crucial for detecting breast cancer early when it’s most treatable.”
But, she said, regular at-home exams help empower women to notice changes and seek medical attention promptly when there’s a sign of a potential problem.
“A medical professional can identify abnormalities such as lumps or calcifications that may indicate cancerous growths,” Hunter said. “Regular screening mammograms can significantly reduce the risk of dying from breast cancer by detecting it in its earliest stages.”
If a patient is established as high risk for breast cancer, she said the first step is genetic testing to determine any mutations in genes that could increase a lifetime risk of developing breast cancer. The second route is to use a risk assessment calculator model, which uses a patient’s personal and family history to determine lifetime risk.
“Screening recommendations may be tailored based on individual risk factors and genetic test results,” Hunter said. “High-risk individuals require more frequent and intensive screening for breast cancer than the general population. This typically includes a combination of breast imaging tests such as mammograms as well as breast MRI.”
It is also helpful, she said, to include lifestyle modifications such as remaining at a healthy weight, exercising regularly, and limiting alcohol consumption.
Other strategies for high-risk patients include chemoprevention — using medications such as tamoxifen or aromatase inhibitors to reduce breast cancer risk — and risk-reducing surgeries such as prophylactic mastectomy or oophorectomy.
Hunter said that being able to educate and empower patients about their breast health, risk factors, available screening, and prevention strategies is a part of the job that brings her a lot of satisfaction.
“My favorite part about being a high-risk breast clinic physician assistant and working with patients is the opportunity to make a meaningful difference in their lives during what can be a vulnerable and challenging time,” Hunter said.
This is, after all, her dream job, Hunter said, which began after she graduated with a master’s degree in physician assistant studies from the University of Mary Hardin at Baylor in Texas, and was introduced to breast cancer care.
“There were such great relationships and bonds between the provider and patient,” Hunter said. “I knew it was where I wanted to work.”
And when her fiance, Tyler, received orders to be stationed at Fort Liberty, the stars aligned for her at Cape Fear Valley Health when a fellow physician assistant in Texas told Hunter about Dr. Sawyer.
“I was on the phone with her the next day,” Hunter said. “She told me that my resume had fallen from the sky and it was meant to be.”
A physician assistant position had just opened for the new High Risk Breast Clinic and Keri Terry, the director of surgical services, was hiring.
“I never thought I’d be able to start in my dream specialty,” Hunter said.
Knowing she plays a role in improving the quality of life and outcomes for her patients brings her great fulfillment and reinforces her passion for service, she said.
“Being able to witness the resilience and strength of patients as they navigate their journey is incredibly inspiring,” Hunter said. “I love being able to help patients make informed decisions about their care and actively participate in their treatment plans.”
It is that active and open communication that helps patients like Stephanie feel at ease.
Stephanie said her priorities these days are spending time with her husband Ryan and daughters Hannah and Rylan, working at My Orthodontist — known to most as Stout & Booth Orthodontics — and attending Jesus First Church. Her priority is not worrying about breast cancer, Stephanie said.
“My 15-year-old daughter keeps me busy with dance, cheer, and school,” Stephanie said. “We do a lot of traveling with her competitive dance team.”
Meanwhile, she’s screened regularly.
“Working with Dr. Sawyer and Hunter has given me peace of mind,” Stephanie said. “They are very knowledgeable and anyone who sees them is in great hands.”
Hunter said the clinic is where she is meant to be and where she can offer compassion, empathy, and encouragement to each patient who comes into her office.
“It reinforces my commitment to providing compassionate care and advocacy for each individual under my care,” Hunter said.
The High Risk Breast Clinic is located at Cape Fear Valley Health General Surgery Village Surgical at 1841 Quiet Cove in Fayetteville and can be reached at 910-323-2626.
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