RISK FACTORS, INVESTIGATIONS & DIAGNOSIS
RISK FACTORS
- Strong family history:
- First-degree male relative with breast cancer o First-degree relative with breast cancer < 40 years o First-degree relative with bilateral breast cancer < 50 years o Two first-degree relatives with breast cancer
- One first-degree and one second-degree relative with breast cancer o One first/second-degree relative with breast cancer and a first-degree relative with ovarian cancer
- Developed world
- Lifestyle factors: alcohol, smoking, diet, obesity, lack of exercise
- High socioeconomic class
- Increasing age
- HRT use
- No breastfeeding history
- Combined oral contraceptive pills
- Early menarche
- Late menopause
- Delayed first pregnancy
- Nulliparity
- Radiation exposure
- Genetic: BRCA1 and BRCA2
INVESTIGATIONS & DIAGNOSIS
Breast screening:
- 3 yearly recalls between the ages of 50-70
- Outside age range: self-referral or via breast cancer services/GP
- Strong family history: referral indicated.
PROGNOSIS
Early detection through screening reduces breast cancer mortality
KEY INFORMATION
- Breast screening programmes are vital for early detection
- A strong family history warrants referral
- Multiple modifiable risk factors exist.