Breast health history and quantitative risk assessment are used to stratify patients into Very High, Elevated/High or Average risk categories. The figure below provides a management strategy for women in each of these risk categories.

*IBC = Invasive Breast Cancer **CBE = Clinical Breast Exam

¹ For more accurate risk assessment of mixtures of 1 st and 2 nd degree relatives consult the Claus model.
² Women on combined hormone replacement therapy for greater than 10 years have approximately twice the risk of age-matched women who have never used hormone replacement therapy.
³ More than half of women diagnosed with breast cancer have no known risk factors.
⁴ Sufficient evidence is not available at this time to make a definitive recommendation.
⁵ Consider increased imaging surveillance such as breast MRI or ultrasound and initiation of mammography before age 40.
⁶ These patients should also be considered for prevention clinical trials.

*Risk Assessment Working Group: Terry Bevers, Linda Frame, Darius Francescatti, Anne-Renee Hartman, Alan Hollingsworth, Suzanne Klimberg, Monica Morrow, Wendy Mikkelson, Lisa Newman, Joyce O’Shaughnessy, Freya Schnabel, Eva Singletary, and Victor Vogel, Chair.

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