CancerIQ helps school administrator find cancer early

Kelli Ballard and her family after the final treatment

Like many of us, Kelli Ballard, a school administrator from Washington, Illinois, hoped after a tumultuous 2020 that 2021 would be a better year. It didn’t quite turn out that way. In January of last year, as the new school semester began at her K-8 school, Ballard, then 42, received a phone call that would change everything.

Ballard learned that she had three breast tumors. Tests showed she had stage 1a ductile invasive breast cancer.

“They weren’t bringing people because of COVID and so it was really difficult. I actually had a co-worker who had had breast cancer the year before and she was there with me that day when I found out and she was just my huge support system.

It was all of a sudden. Ballard’s cancer journey began when after a few years of taking CancerIQ Assessment before each mammogram, she finally decided to tell someone about her high risk score. The Chicago-based startup’s five-minute online tool flags patients at hereditary cancer risk, based on the Personal and Family History Questionnaire.

Ballard consulted with Michele Settelmyer, an advanced practice registered nurse at OSF HealthCare and CancerIQ champion specializing in genetics. Ballard pursued genetic testing based on her “high risk” result.

“I want to live a long life and enjoy my family. It really settled in and I thought, ‘OK, I have to figure this out and get over it.’ “

His results did not show mutations for the BRCA1 and BRCA2 genes, which could indicate a risk of breast or ovarian cancer. But Ballard’s results indicated she had a 50% higher risk of developing breast cancer based on her family history, which included her mother, paternal grandmother, two paternal aunts and a maternal aunt, who all had breast cancer. With this higher risk, Ballard was given a more aggressive screening plan that added a breast MRI six months after each mammogram.

“I didn’t realize they had a whole plan of preventative steps or ways of monitoring in place over the years, so I wasn’t really done, but I was happy; I was happy about that, because that risk was so much higher.

Ballard’s mother was in her 50s when she was diagnosed with stage 0 breast cancer, indicating that the cancer is non-invasive or contained in the milk ducts, but can spread without treatment. A survivor of radiation, her mother’s successful journey inspired Ballard to stay vigilant, even as she was grateful to receive a booster from the OSF in December 2020.

It was this MRI that revealed Ballard had the tumors and a biopsy revealed that the one in her left breast was cancerous. With the support of her husband, her then nine-year-old daughter, and many other family members and friends, Ballard underwent a lumpectomy and 21 sessions of radiation therapy, which she received five days a week for a month. It was a difficult time, but Ballard is very grateful for the increased screening plan developed for her.

Cancer free and enjoying life

“Finding out of course it was small and we caught it early, just made me grateful that I did. You know, if I had waited six more months until my regular mammogram, it (the tumor) could have been a lot bigger at that time or it could have been a lot bigger, so I was really grateful for the plan that was put in place.

Ballard was officially declared a survivor last summer! Although she remains cancer-free after her most recent mammogram, she will continue to follow the more rigorous screening plan.

CancerIQ is among the strategies deployed by OSF Innovation as it seeks to expand the use of precision medicine to improve patient care, including prevention and treatment outcomes.

More than 75,600 OSF HealthCare patients have had a CancerIQ assessment since 2015, when it was first launched as part of a OSF innovation pilot project at OSF Breast Health Centers in Peoria. Of the patients who participated in the assessment, 30% were at high risk for cancer and were offered the option of further screening and seeing a clinician trained in genetic cancer risk assessment. This resulted in over 3,100 changes to care plans.

Ryan Luginbuhl (pronounced loo-gun-BEWL), director of oncology services for OSF HealthCare, says these changes can range from MRIs, prophylactic surgeries and vaccinations, to home screening kits, early detection tests for multiple cancers (MCED), along with possible interventions on lifestyle, education and connection to social resources.

“So they might have a blood test that identifies genetic risks for cancer, and then they might say, ‘Instead of having your mammogram once a year, you’re going to have it twice. So that really allows a clinician to tailor a screening and prevention plan.

The ultimate goal is to expand the use of CancerIQ across OSF hospitals and clinics, including a new OSF Healthcare Cancer Institute being built in Peoria that will provide all services and support under one roof. It will house additional staff to help people who learn they are at higher risk of cancer.

Luginbuhl says CancerIQ can be as important as mammograms, colonoscopies, low-dose CT scans and other cancer screenings.

“It’s a validated tool and I think it’s a very important tool that we need to push just as much as the traditional cancer screenings that we think about.”

Tom Cox, director of medical imaging and outpatient oncology services at OSF HealthCare Saint Francis Medical Center in Peoria, says regular and early administration of CancerIQ — long before typical screenings are suggested — is important because Family history may dictate earlier screenings than recommended since a person’s family medical history may change over time.

“The overall strategy for OSF HealthCare is that we want to start doing screening at many entry points at different ages so that we can start designing this risk mitigation plan where you understand what you are the most at risk and what you can do to prevent it.

Because CancerIQ is cleared by the Food and Drug Administration as a tool to identify hereditary cancer risks, Cox says genetic testing that follows evaluation is often covered by insurance. If you have concerns about cancer due to your family history, be sure to talk to your doctor about next steps.

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Martha K. Merrill