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Home > Understanding Breast Cancer > Early Detection & Screening > Breast Cancer Screening Recommendations for Women at Higher Risk

  


Breast Cancer Screening Recommendations for Women at Higher Risk

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Regular screening tests are very important for women who are at a higher risk of breast cancer. A woman is considered at higher risk if she has one factor that greatly increases her risk or several factors that together increase risk. Your health care provider may use different tools to assess your risk and help you make a breast cancer screening plan. For more on breast cancer risk, see the Risk Factors and Prevention section.

Factors that increase breast cancer risk a great deal include:

The American Cancer Society and the National Comprehensive Cancer Network recommend that women at high risk for breast cancer be screened every year with MRI along with mammography, starting at earlier ages and perhaps more often than women at average risk [7,45-46]. Combined with standard mammography and clinical breast exam, ultrasound may also be useful for detecting cancer in women at higher risk. Any decisions about breast cancer screening should be made after talking with your health care provider.

Magnetic resonance imaging (MRI )

Magnetic resonance imaging (MRI) uses magnetic fields to create an image of the breast. MRI is more invasive than mammography because a contrast agent is injected before the procedure [25]. At this time, MRI is most often used in breast cancer diagnosis and staging, rather than in early detection. However, there is growing evidence that MRI along with mammography, compared to mammography alone, can increase detection of breast cancer in certain groups of women at higher risk due to a BRCA1 or BRCA2 gene mutation or with a strong family history [47-50]. Because insurance coverage varies, you may wish to talk to your insurance provider before getting MRI screening.

Find out more on MRI as a screening tool for women at average risk of breast cancer.

Find out more on BRCA1/2 genetic mutations.

Figure 3.5 below outlines the American Cancer Society and National Comprehensive Cancer Network recommendations for women at higher risk. 

 

Figure 3.5: Breast cancer screening recommendations for women at higher risk of breast cancer
Risk Factor Screening Schedule

Clinical Breast Exam

Mammogram

MRI in Combination with Mammography

Lobular carcinoma in situ (LCIS) or atypical hyperplasia Every 6-12 months Every year Talk to your health care provider

Carrier of BRCA1 or BRCA2 mutation

Every 6-12 months Every year starting at age 25 Every year starting at age 25
First-degree relative of BRCA1 or BRCA2 carrier, but have not been tested for these genetic mutations Every 6-12 months Every year starting at age 25 Every year starting at age 25
Strong family history of breast or ovarian cancer (for example, two or more first-degree relatives with breast cancer or two or more with ovarian cancer)  Under age 25
Every year Not recommended  Not recommended
 Age 25 and over
Every 6-12 months

Every year starting at age 5-10 years prior to the youngest breast cancer case in the family

Every year starting at age 5-10 years prior to the youngest breast cancer case in the family

Radiation treatment to the chest between ages 10 and 30 years
 
 
 
Under age 25 
Every year Not recommended Not recommended
Age 25 and over  
Every 6-12 months Every year starting 8 to 10 years after radiation exposure or at age 40  Every year starting 8 to 10 years after radiation exposure or at age 40

Women with Li-Fraumeni, Cowden or Bannayan-Riley-Ruvalcaba syndrome and their first-degree relatives

Every 6-12 months Every year starting at age 30 Every year starting at age 30
Personal history of cancer (including DCIS)  Every year Every year Talk to your health care provider
Women with dense breast tissue Every year Every year Talk to your health care provider
Risk Category Clinical Breast Exam Mammogram MRI in Combination with Mammography

Women ages 35 and older with a 5-year risk of invasive breast cancer of 1.7 percent or higher

(Estimate your five-year risk or find out more information on risk.)

Every 6-12 months Every year Not recommended

Women at 15 to 20 percent greater than average lifetime risk of invasive breast cancer

(Estimate your five-year risk or find out more information on risk.)

Every year Every year Talk to your health care provider

Women at greater than 20 percent average lifetime risk of invasive breast cancer

(Estimate your five-year risk or find out more information on risk.)

 

Every year 
Every year starting at age 30 Every year starting at age 30

 

 
Adapted from American Cancer Society's Detailed Guide: Breast Cancer, 2009 and NCCN Clinical Practice Guidelines in Oncology: Breast cancer screening and diagnosis, v.1.2009 [7,46].

Breast self-exam

Breast self-exam is a tool that can be used to increase awareness of breast cancer and to learn about what changes in the breast should be reported to your health care provider. Learn more about breast self-exam.

Updated 10/05/09

 

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