By vgreene, 7 November, 2019 If BRCA Cowden PTEN hamartoma tumor syndrome Examine q6 12mo starting at 25 yo 2 ACOG6 10 recommends q6mo
By vgreene, 7 November, 2019 If 20 lifetime risk per FHx based tool Recommend clinical encounter q6 12mo starting from when increased risk first identified but not before 21 yo 1 10 Data on utility limited 7
By vgreene, 7 November, 2019 Stop screening Continue as long as pt in good health4 and life expectancy exceeds 5 7y 9
By vgreene, 7 November, 2019 If 5-yr Gail Model risk of invasive breast CA ≥1.7% (pts ≥35 yo): annual mammogram, once identified as increased risk; consider tomosynthesis and risk reduction strategies (NCCN11)
By vgreene, 7 November, 2019 If high risk due to FHx: Start annual screening 10y before youngest 1st-degree relative dx, but not
By vgreene, 7 November, 2019 Start screening at 30 yo for most pts 4 although ACR3 encourages pts including those w Cowden PTEN hamartoma tumor per NCCN2 to undergo breast CA risk assessment by 25 yo Consider shared decision making 4 Start annual mammo w tomosynthesis 10y before youn
By vgreene, 7 November, 2019 Annual breast MRI mammogram recommended 1 3 4 ACR3 rates tomosynthesis equivalent to mammography ACR 9 NCCN recommends mammo w tomosynthesis to reduce callbacks and improve detection 1 5 ACR specifies MRI w and w o contrast ACR 9 Use U S if MRI not an opt