Breast cancer risk assessment continues to evolve as emerging knowledge of breast cancer risk drivers and modifiers enables better identification of high‐risk women who may benefit from increased screening or targeted risk‐reduction protocols. The ongoing development of breast cancer Risk Assessment and Management Programs (RAMPs) presents an opportunity to decrease breast cancer disease incidence with evidence‐based interventions. The goal of this review was to provide a practical guide for providers seeking to establish or update a breast cancer risk assessment and management program. We outline genetic/familial, personal, reproductive, and lifestyle‐related factors while discussing the incorporation of risk modeling for precise risk estimate personalization. We further describe the process for determining a risk management plan: information gathering, generation of a risk profile, and articulation and implementation of risk reduction. We also include an overview of clinical workflows in breast cancer management programs and underlines the logistics of establishing a program as well as general principles for guiding the formulation of an individualized risk management plan. We discuss practical considerations, such as clinic structure and operation, allocation of resources, and patient education. Other critical aspects of program design, including identification of the target population, delineation of the core components of the clinical experience, definition of provider roles, description of referral mechanisms, and the launching of a marketing plan are also addressed. The process of risk assessment is both anxiety‐provoking and empowering for women at increased risk. New knowledge has enabled strategies to both understand the risk and control it through evidence‐based risk management. These benefits can now be realized by an increasing number of unaffected, high‐risk patients collaborating with risk management practitioners. Continuation of these efforts will lead to further progress in both risk stratification and risk management of women at elevated breast cancer risk in the near future.

NURSES IN advanced practice are expanding the roles they perform. NURSE PRACTITIONERS (NPs) are the largest group of advanced practice nurses, and they have moved beyond primary care to practice in acute care environments, including peri‐operative settings. THIS ARTICLE provides a brief overview of advanced practice nursing and describes the role of NPs in a hospital‐based ambulatory surgery unit (ASU). THE ASU NPs provide preoperative care and ensure that patients are ready for surgery, which minimizes OR delays. AORN J 79 (March 2004)

Nurses have a significant role in the primary prevention of hypercholesterolemia through public and patient education. In addition, nurses have the potential to make significant impact on reducing the cardiovascular risk associated with hypercholesterolemia through effective use of nursing interventions. Early identification of patients with hypercholesterolemia and aggressive life-style modification strategies can lead to a reduction in cholesterol levels and CHD risk.