Editing Breast screening (section)

== BreastScreen (guidelines correct as of 2021) ==

* Two-yearly mammograms to those who are asymptomatic and age 50-74
* Patients aged 40-49 or 75+ are eligible too but won't be invited
* Diagnosed with breast cancer/DCIS >5 years ago: annual mammograms
* LCIS, ADH, ALH: annual mammogram up until age of 74
* Biennial screening should continue while a woman's life expectancy is >10 years

=== 1. At or slightly above average risk ===
'''Covers more than 95% of the female population'''

As a group, risk of breast cancer up to age 75 is between 1 in 11 and 1 in 8. This risk is no more than 1.5 times the population average.

* No confirmed family history of breast cancer
* One 1° relative diagnosed with breast cancer at age 50 or older
* One 2° relative diagnosed with breast cancer at any age
* Two 2° relatives on the same side of the family diagnosed with breast cancer at age 50 or older
* Two 1° or 2° relatives diagnosed with breast cancer, at age 50 or older, but on different sides of the family (ie one on each side of the family)

=== 2. Moderately increased risk ===
'''Covers less than 4% of the female population'''

As a group, risk of breast cancer up to age 75 is between 1 in 8 and 1 in 4. This risk is 1.5 to 3 times the population average.

* One 1° relative diagnosed with breast cancer before the age of 50 (without the additional features of the potentially high-risk group – refer to category 3)
* Two 1° relatives, on the same side of the family, diagnosed with breast cancer (without the additional features of the potentially high-risk group – refer to category 3)
* Two 2° relatives, on the same side of the family, diagnosed with breast cancer, at least one before the age of 50, (without the additional features of the potentially high-risk group – refer to category 3)

Mammogram annually from 40-49, then every two years 50-74. 

=== 3. Potentially high risk ===
'''Covers less than 1% of the female population'''

As a group, risk of breast cancer up to age 75 is between 1 in 4 and 1 in 2. Risk may be more than 3 times the population average. Individual risk may be higher or lower if genetic test results are known.

* Women who are at potentially high risk of ovarian cancer
* Two 1° or 2° relatives on one side of the family diagnosed with breast or ovarian cancer plus one or more of the following on the same side of the family:
** additional relative(s) with breast or ovarian cancer
** breast cancer diagnosed before the age of 40
** bilateral breast cancer
** breast and ovarian cancer in the same woman
** Jewish ancestry
** breast cancer in a male relative.
* One 1° or 2° relative diagnosed with breast cancer at age 45 or younger plus another 1° or 2° relative on the same side of the family with sarcoma (bone/soft tissue) at age 45 or younger.
* Member of a family in which the presence of a high-risk breast cancer gene mutation has been established.

Annual MRI until 40yo

Annual MRI + MMG 40-60

Annual MMG >60

Consider chemoprophylaxis, prophylactic mastectomy




[[Category:Breast]]