Editing Breast cancer (section)

== '''Care of high-risk patients''' ==

* High-risk patient is defined as a 5-year calculated risk of >1.66% using Gail model, which is the average risk of a 60yo woman
* For patients with specific genetic mutations, see separate topic - this is for general high-risk
* Close surveillance
** Monthly self-examination
** Semi-annual clinical breast examination
** Annual mammography begging at age 25 or 10 years before the earliest age of onset of breast cancer in a family member
** Consider annual screening MRI
* Chemoprevention
** Tamoxifen can reduce the risk of OR-positive cancers, but at the cost of endometrial cancers and PEs, so probably quite a high risk level is necessary to consider it
* Bilateral prophylactic mastectomy
** Reduces the risk of breast cancer development in high-risk women by 90%