FOLLOW-UP OPTIONS FOR WOMEN IN DIFFERENT
RISK CATEGORIES |
Risk Category |
Lifetime Risk (%) |
Clinical Breast Examination Schedules*** |
Mammogram Schedule |
Other Opinions |
| No risk factors |
11-12 |
Annual after age 30 y |
Every 1-2 y after age 40y, annual after age 50 y |
Frequency of mammograms before age 50 y |
| Two or more reproductive or hormonal risk factors* |
10-20 |
Annual after age 30 y |
Annual after age 40 y |
|
| Weak family history** |
15-20 |
Annual after age 30 y |
Annual after age 40 y |
|
| Strong family history** |
>20 |
Annual after age 25 y, twice yearly after age 30 y |
Annual after age 35 y or 5 y younger than youngest affected relative |
Chemoprevention trials, prophylactic mastectomy, genetic testing |
| Carrier of known breast cancer susceptibility gene or identifiable breast cancer syndrome r very strong family history |
20-85 |
Twice yearly after age 25 y |
Annual after age 25 y |
Chemoprevention trials, prophylactic mastectomy, genetic testing |
| Atypical hyperplasia with a negative family history |
15-20 |
Annual after diagnosis |
Annual after diagnosis |
Chemoprevention trials |
| Atypical hyperplasia with a positive family history |
>20 |
Twice yearly |
Annual after age 40 y, annual after diagnosis |
Chemoprevention trials, prophylactic mastectomy |
| Lobular carcinoma in site |
20-30 |
Twice yearly |
Annual after diagnosis |
Chemoprevention trials, prophylactic mastectomy |
*Reproductive and hormonal risk factors include menarche at age 21 years or earlier, menopause at age 55 years or later, nulliparity, first full term pregnancy after 30 years, current use of postmenopausal hormone replacement therapy.
**Weak family history is defined as two or fewer second-degree or more distant relatives with postmenopausal breast cancer.
Strong family history is defined as any first-degree relative with breast cancer, three or more relatives with breast cancer, or any second-degree relative with breast cancer before 40 years.
Very strong family history is defined as two or more first-degree relatives with breast cancer or ovarian cancer, one or more first-degree relatives with breast cancer before age 40 years, or any first-degree relative with bilateral premenopausal breast cancer.
- Lifetime risk as calculated using the Gail, Claus or other model of breast cancer risk. Risk figures for women with no risk factors end for those with lobular carcinoma in situ from historical data
***Monthly breast self-examination is recommended for women in all risk categories.
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