Breast Cancer Risk and Screening Guidelines Factsheet

Lifetime cancer risks (<70 yrs)

Risk Level Breast cancer Ovarian cancer

Average (general population)

~8-12%

~1-2%

Moderate (familial)

~15-25%

~4-6%

High (hereditary)

> 40%

> 15% (HBOC related risks)

Screening Guidelines

Women at all risk levels should practice the following preventative behaviors:

  • Breast self-awareness
  • Healthy lifestyle
  • Ovarian cancer symptom awareness
  • Clinical breast exam
  • Mammogram

Clinical breast exams and mammograms should be performed at different intervals depending on risk level, as indicated below.

Average Risk

  • Clinical breast exam: every 1-3 years beginning at age 25
  • Mammogram: at least every 2 years for ages 50-74; Shared decision making for ages 40-49

Moderate (Familial) Risk

  • Clinical breast exam: annual or semi-annual from age 25
  • Mammogram: annual from age 40 or 10 years before earliest family diagnosis
  • Consider cancer genetic counseling
  • Breast MRI
  • Consider chemoprevention

High Risk

  • Clinical breast exam: annual or semi-annual from age 25
  • Mammogram: annual from age 25-30 or 10 years before earliest family diagnosis
  • Cancer Genetic Counseling
  • Breast MRI: Annual from age 25-30 or 10 years before earliest family diagnosis
  • Consider chemoprevention
  • Ovarian cancer screening via CA-125 and/or transvaginal ultrasound: Consider every 6 months from age 30 or 5-10 years before earliest family diagnosis if BSO not performed
  • Consider prophylactic mastectomy
  • Prophylactic bilateral salphino-oophorectomy (BSO): Ideally between 35-40 and upon completion of childbearing

Editor's Note

Developed by the National Coalition for Health Professional Education in Genetics.