Beaumont Hospital Breast Service Breast Cancer Family Risk Assessment Guidelines Low Risk Medium Risk High Risk One 1st degree relative with breast cancer > 40 years. One 2nd degree relative at any age. One 1st degree relative with breast cancer < 40 years. Two 1st or 2nd degree relative with breast cancer at an average age of >50 years. Three 1st or 2nd degree relatives with breast cancer at an average age of >60 years. Two 1st or 2nd degree relative with breast cancer at an average age of < 50 years (One must be 1st degree relative). Three 1st or 2nd degree relatives with breast cancer <60 years (one must be 1st degree relative). Four relatives with breast cancer at any age (one must be a 1st degree relative). Ovarian Cancer One relative with ovarian cancer at any age PLUS on the same side of the family there is: One 1st degree relative with breast cancer before age of 50. One additional relative with ovarian cancer at any age. Two 1st or 2nd degree relatives with breast cancer at an average age of <60. Bilateral Breast Cancer One 1st degree relative with cancer in both breasts before average age of 50. One 1st or 2nd degree relative with bilateral breast cancer AND one 1st or 2nd degree relative with breast cancer <60 years. Male Breast Cancer One male breast cancer at any age PLUS ON SAME SIDE OF FAMILY: One 1st or 2nd degree relative with breast cancer before 50. Two 1st or 2nd degree relatives with breast cancer before average age of 60. Imaging Required Base line mammogram if over 35years old. No further imaging required until National Breast Screening Programme at 50 years old Imaging Required Baseline mammogram if over 35 years old Annual Mammography for women aged between 40-49, (G.P. to arrange same). Women aged over 50 years, mammography in the National Breast Screening Programme. 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 IBIS Risk Assessment Lifetime risk of breast cancer is greater than 17% but less than 30%. A 3%-8% risk of developing breast cancer in the next 10 years for women aged 40-49. 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. Follow up Discharge to primary care Mammography unit will facilitate annual mammography as requested by primary care physician Imaging Required IBIS score >30% Annual MRI from 30 years old & Annual mammography from 40 years old. IBIS score <30% Annual mammography from 35 years. (Review need for MRI at 50years old). IBIS Risk Assessment Lifetime risk of breast cancer is 30% or greater. Risk of faulty gene: BRCA1, BRCA2 or TP53 gene is 20% or greater. A greater than 8% risk of developing breast cancer in next 10 years for women aged 40-49 1st Degree Relative Mother Father Daughter Son Sister Brother 2nd Degree Relative Grandparent Grandchild Aunt Uncle Niece Nephew Half Sister Half Brother 3rd Degree Relative Great-grandparent Great-grandchild Great Aunt Great Uncle Cousin Follow up Annual outpatient review with clinical examination and imaging results Reviewed 10/11/15