AGE TO BEGIN
Breast awareness - Women should be familiar with their breasts and promptly report changes to their healthcare provider. Periodic, consistent breast self-examination (BSE) may facilitate breast awareness.
Clinical encounter, including clinical breast exam, ongoing risk assessment and risk-reduction counseling
When genetic risk is identified, but not before age 21
Every 6 to 12 months
Mammography with consideration of tomosynthesis and consideration of breast MRI with contrast
Age 40, or modified to a younger age based on the family history of breast cancer
Consider additional risk-reduction strategies.
For patients with a family history of pancreatic cancer, consider available options for pancreatic cancer screening, including the possibility of endoscopic ultrasonography (EUS) and MRI/magnetic resonance cholangiopancreatography (MRCP). It is recommended that patients who are candidates for pancreatic cancer screening be managed by a multidisciplinary team with experience in screening for pancreatic cancer, preferably within research protocols.
Age 50, or 10 years younger than the earliest age of pancreatic cancer diagnosis in the family
Provide education about ways to reduce pancreatic cancer risk, such as not smoking and losing weight.
Incorporating information about increased risk due to gene mutation, start risk and benefit discussion about offering baseline digital rectal examination (DRE) and Prostate Specific Antigen (PSA).15
Individualized, consider annually