Summary of recommendations on surveillance for women with no personal history of breast cancer

Moderate risk High risk
Age Moderate risk of breast cancer 1 High risk of breast cancer (but with a 30% or lower probability of being a BRCAor TP53carrier) 2 Untested but greater than 30% BRCAcarrier probability 3 Known BRCA1or BRCA2mutation Untested but greater than 30% TP53carrier probability 4 Known TP53mutation
20-29 Do not offer mammography Do not offer mammography Do not offer mammography Do not offer mammography Do not offer mammography Do not offer mammography
Do not offer MRI Do not offer MRI Do not offer MRI Do not offer MRI Annual MRI Annual MRI
30-39 Do not offer mammography Consider annual mammography Annual MRI and consider annual mammography Annual MRI and consider annual mammography Do not offer mammography Do not offer mammography
Do not offer MRI Do not offer MRI Annual MRI Annual MRI
40-49 Annual mammography Annual mammography Annual mammography and annual MRI Annual mammography and annual MRI Do not offer mammography Do not offer mammography
Do not offer MRI Do not offer MRI Annual MRI Annual MRI
50-59 Consider annual mammography Annual mammography Annual mammography Annual mammography Mammography as part of the population screening programme Do not offer mammography
Do not offer MRI Do not offer MRI Do not offer MRI unless dense breast pattern Do not offer MRI unless dense breast pattern Do not offer MRI unless dense breast pattern Consider annual MRI
60-69 Mammography as part of the population screening programme Mammography as part of the population screening programme Mammography as part of the population screening programme Annual mammography Mammography as part of the population screening programme Do not offer mammography
Do not offer MRI Do not offer MRI Do not offer MRI unless dense breast pattern Do not offer MRI unless dense breast pattern Do not offer MRI unless dense breast pattern Consider annual MRI
70+ Mammography as part of the population screening programme Mammography as part of the population screening programme Mammography as part of the population screening programme Mammography as part of the population screening programme Mammography as part of the population screening programme Do not offer mammography

[3] Women with Jewish ancestry are around 5–10 times more likely to carry BRCA1 or BRCA2 mutations than women in non-Jewish populations.

[4] In most cases, this will equate to less than a 3% 10-year risk of breast cancer at age 40 years.

[5] National breast screening programmes: England – NHS Breast Screening Programme (NHSBSP); Wales –Breast Test Wales; Northern Ireland – NI Breast Screening Programme

[6] For the purpose of these calculations, a woman’s age should be assumed to be 40 for a woman in her forties. A 10-year risk should be calculated for the age range 40–49.

[7] At the time of publication (June 2013), tamoxifen did not have a UK marketing authorisation for this indication. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council’s Good practice in prescribing and managing medicines and devices for further information.

[8] At the time of publication (June 2013), raloxifene did not have a UK marketing authorisation for this indication. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council’s Good practice in prescribing and managing medicines and devices for further information.