Early Diagnosis

Breast Cancer Screening Guidelines of the Americal Cancer Society

  1. Women should have an annual mammography and clinical breast examination from the age of 40 years. This should continue till women maintain good health
  2. Women between the ages of 20-39 should have a clinical breast examination every one to three years.
  3. Breast self examination has not been proven to reduce breast cancer mortality but should be encouraged as it makes the women aware about the shape and feel of their breasts
  4. Women at high risk should have an annual MRI in addition to mammography.  Women at moderate risk for breast cancer may add MRI to mammography. MRI need not be performed for individuals with a risk less than 15%. MRI is more sensitive than a mammogram and picks up more false positives than a mammogram. It can not replace a mammogram because the mammogram picks up some lesions not picked up by MRI. High risk women are those women who have a more than 20% lifetime risk of breast cancer and women at moderate risk are those with a 15-20% lifetime risk of breast cancer.

1.

High Risk

Moderate Risk

  • Have a known BRCA1 or BRCA2 gene mutation
  • Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
  • Have a lifetime risk of breast cancer of 20% to 25% or greater, according to risk assessment tools that are based mainly on family history. Many risk assessment models are available (Gail model, the Claus model, and the Tyrer-Cuzick model).Risk calculators are available at:
  • Had radiation therapy to the chest when they were between the ages of 10 and 30 years
  • Have Li-Fraumeni syndrome, Cowden syndrome, or hereditary diffuse gastric cancer syndrome, or have one of these syndromes in first-degree relatives

  • Have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based mainly on family history. Many risk assessment models are available (Gail model, the Claus model, and the Tyrer-Cuzick model). Risk calculators are available at:
  • Have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
  • Have extremely dense breasts or unevenly dense breasts when viewed by mammograms

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