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Breast Cancer Screening: Increased Risk

Women at increased risk have a higher chance of getting breast cancer than women at average risk. The exams you get and how often you are tested depends on what puts you at increased risk for breast cancer.

Women at increased risk include those who have a:

  • History of radiation treatment to the chest
  • Genetic mutation, including an abnormality in the BRCA 1 or BRCA 2 genes, Li-Fraumeni Syndrome, CDH1, Cowden's Syndrome or Bannayan-Riley-Ruvalcaba Syndrome
  • History of lobular carcinoma in situ
  • Five-year risk of breast cancer 1.7% or greater at age 35 or older, as defined by a Gail Model calculation. Calculate your risk using the Gail Model
  • A life-time risk of breast cancer 20% or greater, as defined by models dependent on family history. Women with a strong family history of breast cancer should consider speaking with a genetic counselor to learn more about these models and have their risk determined.

If you fit one or more items from the list above, you should follow one of the screening schedules below. These guidelines are for women without any breast cancer symptoms.  If you have symptoms, you should see your health care provider as soon as possible.

Radiation Treatment

Women who received radiation treatment to the chest during their teens or twenties should follow the guidelines below.

Age 24 and younger, you should:

Age 25 and older, you should:

  • Have a mammogram every year and clinical breast exam every 6 to 12 months. You should begin these tests 8 to 10 years from the age you started radiation treatment but no later than age 40. For example, a woman who received radiation treatment at age 25 will begin testing between ages 33 and 35.
  • Consider breast MRI once a year as an additional test
  • Practice breast awareness

Genetic Predisposition 

Women with a genetic mutation, such as a BRCA 1 and BRCA 2 mutation, Li-Fraumeni Syndrome, CDH1, Cowden's Syndrome or Bannayan-Riley-Ruvalcaba Syndrome should follow the guidelines below.

Age 20 to 24, you should:

Age 25 and older, you should:

  • Have a mammogram every year and clinical breast exam every 6 to 12 months. You should begin testing 5 to 10 years before the youngest person in your family with breast cancer or at age 25, whichever comes first. For example, a woman whose sister was diagnosed with breast cancer at age 35 would begin testing between ages 25 and 30.
  • Have a MRI once a year as an additional test
  • Practice breast awareness

Lobular Carcinoma in Situ  

Women who have been diagnosed with lobular carcinoma in situ should follow the guidelines below.

Gail Model Greater Than 1.7%  

Women age 35 and older, whose five-year risk of breast cancer is 1.7% or greater according to the Gail Model, should follow the guidelines below. This number is based on a Gail model calculation.

Family History Based on Model Results Greater Than 20%  

Women should follow the guidelines below if their chances of getting cancer in their lifetime is 20% or greater.  This number is based on models that rely on a woman’s family history. Speak with a genetic counselor if you have a strong family history of breast cancer to learn more about these models and to have your risk determined.

  • Have a mammogram every year and clinical breast exam every 6 to 12 months
  • Consider breast MRI once a year as an additional test
  • Practice breast awareness

These screening guidelines apply to women who are expected to live for at least another 10 years. The guidelines are not for women who have a health condition that would make it hard for a health care provider to diagnose or treat breast cancer.

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For Physicians

Use our flowchart to determine cancer screening recommendations for patients. 


© 2014 The University of Texas MD Anderson Cancer Center