Dr. F. Ames Smith, Jr.

After 40 years of productive general and breast surgical work, I have now transitioned to a full-time high risk and risk reduction practice. I am grateful and blessed to have had the opportunity to provide surgical care over that time period. A big thank you to all of my patients. Hereditary risk management has long been a passion and focus for me and now will get 100% of my time and energy.

Aspects of this practice include early detection, diagnosis, prevention and risk reduction, as well as quality of life considerations for high-risk men, women, and their families.

Last week, I had the opportunity to present 16 years worth of data from my hereditary cancer practice to the staff and nurses at Treasure Valley Hospital. This aspect of my practice has been one of the highlights of my career, and I love serving this population of patients and families.

Over this time frame, we tested 2,690 patients and found 239 high risk mutations (137 that were high risk for breast cancer and other cancers, and 52 that had Lynch syndrome).

Consider that each number represents not only a person but also the families that are potentially at risk. In our Boise Hereditary Cancer Risk Clinic, we aim to make this increasingly a team effort with other associated specialties, which is critical (credit for helping me compile and present my data to Martel Gomez).

I'm excited to announce that Lake City PT and Physician Specialists Northwest will be moving into a renovated space in early August at Suite 150 in the 8950 W Emerald St Office Building. This is a very convenient location close to Treasure Valley Hospital. We are currently seeing patients at Suite 195, but hope to see you in the new office soon.

The Hereditary Cancer Risk Clinic in Boise is dedicated to identifying and managing patients and families with hereditary cancer predisposition. Roughly 10% of cancers have a hereditary component, and if present can affect 50% of direct blood relatives. We see multiple different mutations, each with specific associated cancer risks. Often, we see families with multiple or very early age cancers of the breast, ovaries, pancreas, colon, or other sites.

I have had the opportunity to provide this service for patients since 2008, and it is one of the favorite aspects of my practice. We manage these patients ideally as a multi-disciplinary team, and we are fortunate in this region to have expertise in all the critical disciplines including cancer genetics, high risk pancreatic screening, gynecology/gyn oncology, gastroenterology, breast surgery, colorectal surgery, among others.

I’m hoping also that some of my former patients will reach out if ever needed. You can call 208-400-5131 to schedule an appointment.

Home | F. Ames Smith Jr. MD Physician Specialists Northwest is a breast cancer surgery and hereditary cancer screening and management practice serving the Inland Northwest region since 2022. Dr. F. Ames Smith Jr, an experienced breast cancer surgeon, founded this group with the purpose of bringing technical expertise and multi...

I’m delighted to announce the relocation of my dedicated breast surgical and hereditary cancer risk management practice to Boise, Idaho.

I hope to open my physical office by March 1, and am available by telehealth currently for patients in Washington State and Idaho. I’m grateful for the opportunity to provide care in this setting, and look forward to this eagerly.

Home | F. Ames Smith Jr. MD Physician Specialists Northwest is a breast cancer surgery and hereditary cancer screening and management practice serving the Inland Northwest region since 2022. Dr. F. Ames Smith Jr, an experienced breast cancer surgeon, founded this group with the purpose of bringing technical expertise and multi...

Physician Specialists Northwest is open for business!

This a breast surgical specialty practice along with hereditary cancer screening and management. Call 208-400-5131 for consultation or appointment. Email questions to [email protected].

I’m announcing the opening of the Hereditary Cancer Risk Clinic NW which focuses on identification and management of moderate and high risk gene mutations that predispose to cancer risk. About 5-13% of cancers are genetically predisposed, and patients with these mutations can develop multiple different cancer types, often at much earlier ages. Affected cancer types include: breast, ovarian, uterine, colon, prostate, pancreatic, thyroid, melanoma, sarcoma, among many other cancer types. If identified, there are established guidelines for screening and prevention in most cases that can help reduce risk for these patients. Multiple societal guidelines recommend appropriate screening and testing for these mutations. I will see patients in office or via telehealth.

For an appointment, please call 208-400-5131.

Best regards,

F. Ames Smith Jr. MD
Hereditary Cancer Risk Clinic NW Director

Physician Specialists NW
www.physicianspecialistsNW.com
P: 208-400-5131
F: 208-277-3448

One of the common hereditary mutations is the BRCA1 mutation. About 5-10% of breast cancer cases and 15% of ovarian cancer cases may be related to an inherited change in this gene location. The BRCA1 mutation can be passed down to either a male or female child in an autosomal dominant fashion. This means that each first degree relative (parents, siblings, children) of a mutation carrier has a 50% chance of carrying the same mutation. For females, having a deleterious (harmful) mutation in the BRCA1 gene conveys a very high lifetime risk for breast cancer (46- 87% risk by age 70), ovarian cancer (39-63% by age 70), as well as pancreatic cancer in some families. A simple test with either saliva or blood is able to detect this mutation reliably, and the cost for testing has dropped significantly over time. Most insurers will cover testing if a patient meets guidelines for testing, and patients without insurance can do this test for as little as $250. There is value for patients who discover that they carry this mutation as well as for those in affected families who do not carry this high-risk gene mutation. For women who carry a harmful BRCA1 mutation we recommend breast awareness, more frequent clinical breast exams beginning at age 25, consideration for high-risk surveillance with MRI at age 25, and mammogram plus MRI at age 30. We recommend consideration of ovarian surveillance with pelvic ultrasound and CA 125 starting at age 30. There are effective risk reduction strategies for both breast and ovarian cancer including both medical and surgical options. For women with a family history of pancreatic cancer, we recommend referral to a high-risk pancreatic cancer center for consideration of pancreatic surveillance. A good reference for management guidelines can be found at this site: https://myriad.com/gene-results/?gene=BRCA1&allele=1. For men with a BRCA1 mutation, there is an increased risk for prostate cancer, breast cancer, and in some families, pancreatic cancer. There are specific guidelines for surveillance in male BRCA1 carriers as well. A good site for support online for BRCA1 carriers can be found at https://www.facingourrisk.org/.

Dr. F. Ames Smith is able to test for this mutation and counsel regarding available management options. Initial consultation is typically 30 minutes and can be done via telehealth or in office. For patients who wish to test, the saliva kit can be mailed to their home, and the specimen is then mailed to the lab. Turnaround time for the lab is typically 10-14 days. For an appointment, please call 208-400-5131 and check out the website at https://www.physicianspecialistsnw.com/.

Home | F. Ames Smith Jr. MD Physician Specialists Northwest is a unique specialty practice serving the Inland Northwest region since 2022. Dr. F. Ames Smith Jr, an experienced breast cancer surgeon (Austin/Seattle), offers both surgical and hereditary cancer screening services, and has vision toward adding further specialty se...

Dr. F. Ames Smith, Jr. updated their business hours.

A common hereditary mutation is the BRCA2 mutation. About 5-10% of breast cancer cases and 15% of ovarian cancer cases may be related to an inherited change in this gene location. The BRCA2 mutation can be passed down to either a male or female child in an autosomal dominant fashion. This means that each first degree relative (parents, siblings, children) of a mutation carrier has a 50% chance of carrying the same mutation. For females, having a deleterious (harmful) mutation in the BRCA2 gene conveys a very high lifetime risk for breast cancer (43- 84% risk by age 70), ovarian cancer (15-27% by age 70), as well as pancreatic cancer in some families. There is also an elevated risk for melanoma (including ocular melanoma). A simple test with either saliva or blood is able to detect this mutation reliably, and the cost for testing has dropped significantly over time. Most insurers will cover testing if a patient meets guidelines for testing, and patients without insurance can do this test for as little as $250. There is value for patients who discover that they carry this mutation as well as for those in affected families who do not carry this high-risk gene mutation. For women who carry a harmful BRCA2 mutation we recommend breast awareness, more frequent clinical breast exams beginning at age 25, consideration for high-risk surveillance with MRI at age 25, and mammogram plus MRI at age 30. We recommend consideration of ovarian surveillance with pelvic ultrasound and CA 125 starting at age 30. There are also screening guidelines for melanoma. Effective risk reduction strategies are available for both breast and ovarian cancer including both medical and surgical options, as well as melanoma. For women with a family history of pancreatic cancer, we recommend referral to a high-risk pancreatic cancer center for consideration of pancreatic surveillance. A good reference for management guidelines can be found at this site: https://myriad.com/gene-results/?gene=BRCA2&allele=1. For men with a BRCA2 mutation, there is an increased risk for prostate cancer, breast cancer, and in some families, pancreatic cancer, as well as melanoma. There are specific guidelines for surveillance in male BRCA2 carriers as well. A good site for support online for BRCA2 carriers can be found at https://www.facingourrisk.org/.

Dr. F. Ames Smith is able to test for this mutation and counsel regarding available management options. Initial consultation is typically 30 minutes and can be done via telehealth or in office. For patients who wish to test, the saliva kit can be mailed to their home, and the specimen is then mailed to the lab. Turnaround time for the lab is typically 10-14 days. For an appointment, please call 208-400-5131 and check out the website at https://www.physicianspecialistsnw.com/.

Home | F. Ames Smith Jr. MD Physician Specialists Northwest is a unique specialty practice serving the Inland Northwest region since 2022. Dr. F. Ames Smith Jr, an experienced breast cancer surgeon (Austin/Seattle), offers both surgical and hereditary cancer screening services, and has vision toward adding further specialty se...

Dr. F. Ames Smith, Jr. updated their info in the about section.

I have recently relocated my practice to the Northern Idaho region in beautiful Sandpoint. The practice has not yet officially opened, but the target date is mid-April, and I’m excited about this new direction.

I’m forever grateful for the honor and privilege of working at the Polyclinic for the last ten years as well as having cared for innumerable amazing patients along the way. My hope is to remain available for any of my prior patients either in office or by tele-health, if helpful.

The Polyclinic Hereditary Cancer Risk Clinic now has the capability to test for multiple hereditary cancer types with an 84 gene panel. This includes testing for hereditary risk for all the more common cancers such as breast, colon, uterine, ovarian, melanoma, pancreatic (among others), but also includes less common or rare cancer types.

Most cancers are not hereditary (related to an identifiable gene mutation), but approximately 5-10% are. Genetic testing (blood or saliva) is recommended especially if there is a family history of very early age breast cancer (younger than 45), multiple breast cancers, Ashkenazi Jewish ancestry, colon or uterine cancer younger than age 50, ovarian cancer, make breast cancer (among other indications).

Even if a mutation is not identified, there is often a modification of screening and prevention guidelines for patients with a strong cancer family history. We can help with that. This aspect of the practice is dedicated to prevention and early detection. We have been dedicated to this for over 10 years.