Enhancing Breast Cancer Prevention: The Role of Nurse Practitioners and Physician Assistants

Breast cancer prevention has traditionally involved oncologists prescribing risk-reduction medications like tamoxifen to women at higher risk. While effective—halving the risk of developing the disease—this approach can be hindered by concerns about side effects such as hot flashes and joint pain, as well as emotional barriers to long-term preventive therapy. A recent study from the University of Rochester Wilmot Cancer Institute suggests a promising alternative: empowering nurse practitioners (NPs) and physician assistants (PAs)—collectively known as advanced practice providers (APPs)—to lead preventive care.

This innovative model involves APPs working alongside breast surgeons and oncologists to provide high-quality, accessible preventive services. The study indicates that APP-led clinics can deliver comparable rates of preventive medication prescriptions—around 40%—to traditional physician-led care, demonstrating efficiency and cost-effectiveness. For example, a patient named Kathleen Fitzpatrick, from Pittsford, engaged in shared decision-making with her nurse practitioner regarding low-dose tamoxifen. Her choice minimized side effects while addressing her early-stage breast cancer risk, exemplifying personalized, patient-centered care.

The clinic established by Weiss and her team is the first in the Rochester area designed to serve women with early-stage breast disease or increased risk factors like dense breast tissue, family history, or previous radiation exposure. Such clinics offer significant benefits; they alleviate the burden on oncologists, enable early intervention, and support the growing number of breast cancer survivors.

Understanding stage 0 breast cancer, or ductal carcinoma in situ (DCIS), is crucial. With nearly a 100% survival rate, DCIS is confined within the milk ducts but elevates the risk of invasive cancer later. Preventive strategies for DCIS include surgery, regular imaging, and medications such as estrogen modulators (tamoxifen, raloxifene) and aromatase inhibitors (anastrozole, letrozole, exemestane). Yet, predicting which cases will become invasive remains challenging, emphasizing the importance of proactive prevention.

This care model, pioneered by Weiss and her team, underscores a broader shift toward accessible, team-based breast health services. As survivorship increases, ongoing management outside immediate treatment becomes vital, and APP-led clinics serve as a forward-thinking solution to meet these needs.

Source: https://medicalxpress.com/news/2025-05-breast-cancer-nurse-practitioners-physician.html