Summary of breast cancer risk categories, related care settings and management recommendations in women with a family history but no personal history of breast cancer
| Breast cancer risk | Definition of category | Probability of a breast cancer genetic mutationa | Care Setting | Recommendations | |||
|---|---|---|---|---|---|---|---|
| Lifetime breast cancer risk from aged 20 years | Breast cancer risk age 40–50 years | ||||||
| Surveillance | Risk-reducing surgeryb | Chemoprevention for 5 yearsb | |||||
| Near population risk | <17% (= <1 in 6) | <3% | Very low | Primary care | – | – | – |
| Moderate risk | ≥17% but <30% (= >1 in 4) | 3–8% | <10% | Secondary care | Offer annual mammography for women aged 40–49 years and consider for women aged 50–59 years | – | If aged >35 years, consider treatment unless woman has had bilateral mastectomy |
| High risk | ≥30% (=≥1 in 3) | >8% | >10% chance of a faulty gene in the family | Specialist genetic clinic | Offer annual MRI or mammography. Actual procedure based on age of patient and genetic mutation (identified or predicted) | If appropriate, offer mastectomy and bilateral salpingo-oophrectomy | If aged >35 years, offer treatment unless woman has had bilateral mastectomy |