Beaumont Hospital Breast Service Breast Cancer Family Risk

Beaumont Hospital Breast Service Breast Cancer Family Risk Assessment Guidelines Low Risk • One 1 st degree relative with breast cancer > 40 years. • One 2 nd degree relative at any Imaging Required age. • Base line mammogram if over 35 years old. • No further imaging required until National Breast Screening Programme at 50 years old IBIS Risk Assessment • Lifetime risk of breast cancer is less than 17%. • Less than 3% risk of developing breast cancer in the next 10 years for women aged 40 -49. Follow up • Discharge to primary care Significant Factors • Bilateral Breast Cancer • Male Breast Cancer • Ovarian Cancer • Jewish Ancestry • Sarcoma in a relative <45 • Glioma or childhood adrenal cortical carcinomas • Complicated patterns of multiple cancers at a young age. 1 st Degree Relative • Mother • Father • Daughter • Son • Sister • Brother Reviewed 10/11/15 Medium Risk High Risk • Two or 2 nd degree relative with breast • One 1 st degree relative with cancer at an average of < 50 years breast cancer < 40 years. (One must be 1 st degree relative). st nd • Two 1 or 2 degree relative st nd with breast cancer at an average • Three 1 or 2 degree relatives with st breast cancer <60 years (one must be 1 age of >50 years. degree relative). st nd • Three 1 or 2 degree relatives • Four relatives with breast cancer at any with breast cancer at an average (one must be a 1 st degree relative). age of >60 years. Ovarian Cancer • One relative with ovarian cancer at any Imaging Required age PLUS on the same side of the family • Baseline mammogram if there is: over 35 years old § One 1 st degree relative with breast • Annual Mammography for cancer before age of 50. women aged between 40 -49, § One additional relative with ovarian (G. P. to arrange same). cancer at any age. • Women aged over 50 years, § Two 1 st or 2 nd degree relatives with mammography in the breast cancer at an average of National Breast Screening <60. Programme. Bilateral Breast Cancer • One 1 st degree relative with cancer in both breasts before average of 50. IBIS Risk Assessment • One 1 st or 2 nd degree relative with • Lifetime risk of breast bilateral breast cancer AND one 1 st or 2 nd cancer is greater than degree relative with breast cancer <60 17% but less than 30%. years. • A 3%-8% risk of Male Breast Cancer developing breast cancer One male breast cancer at any age PLUS in the next 10 years for ON SAME SIDE OF FAMILY: women aged 40 -49. • One 1 st or 2 nd degree relative with breast cancer before 50. Follow up Imaging • Two 1 st or. Required 2 nd degree relatives with • Discharge to primary care • IBIS score MRI from breast cancer>30% before. Annual average of 60. • Mammography unit will 30 years old & Annual mammography facilitate annual from 40 years old. mammography as • IBIS score <30% Annual requested by primary care mammography from 35 years. physician • (Review need for MRI at 50 years old). 2 nd Degree Relative • Grandparent • Grandchild • Aunt • Uncle • Niece • Nephew • Half Sister • Half Brother 1 st 3 rd Degree Relative • Great-grandparent • Great-grandchild • Great Aunt • Great Uncle • Cousin IBIS Risk Assessment • Lifetime risk of breast cancer is 30% or greater. • Risk of faulty gene: BRCA 1, BRCA 2 or TP 53 gene is 20% or greater. • A greater than 8% risk of developing breast cancer in next 10 years for women aged 40 -49 Follow up • Annual outpatient review with clinical examination and imaging results