Identification and Management for Patients at Increased Risk of Breast Cancer based on Family Cancer History
| Identification of persons at ‘increased risk’ because of family cancer history |
| Breast cancer risk increased among: |
| Women with a mother and/or sister(s), daughter(s) with breast cancer, especially if diagnosed before age 50 years. |
| Women who have a father and/or paternal relatives (grandmother or aunts) with breast cancer, especially if diagnosed before age 50 years. |
| Women who have maternal relatives (grandmother or aunts) with breast cancer, especially if diagnosed before age 50 years. |
| Families with a history of breast and/or ovary and/or colon and rectum cancers among mothers/fathers, brothers/sisters, children, and/or maternal or paternal relatives. |
| Families with a history of cancers and/or inherited conditions or known/suspected gene mutation associated with breast cancer risk (eg, BRCA1/2 mutations, Li Fraumeni syndrome, Ashkenazi Jewish ancestry). |
| Surveillance recommendations for persons at ‘increased risk’ because of family cancer history |
| Beginning at age 30 years (or 10 years before age of earliest case in family): |
| Evaluate family history of cancer and overall health status of patient. |
| Discuss risk status and overall health status with patient and plans for ongoing surveillance, including age to begin mammography. |
| Consider whether involvement in a prevention trial is an option. |
| Consider a consultation with a genetic counselor for risk assessment and possible genetic testing. |