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Genetic Risk Assessment and BRCA Mutation Testing for Breast and Ovarian Cancer Susceptibility
Table 1. Detection and Prevention Recommendations
| Intervention | Average-Risk Women* | High-Risk Women* |
|---|---|---|
| Breast cancer screening | Annual mammography every 1-2 y beginning at age 40 y36 | BRCA mutation carriers: monthly self-examinations beginning by age 18-21 y, annual or semiannual clinician examinations beginning at age 25-35 y, and annual mammography beginning at age 25-35 y37 |
| Ovarian cancer screening | No screening38 | BRCA1 mutation carriers: annual or semiannual screening using transvaginal ultrasonography and CA-125 serum levels beginning at age 25-35 y; optional for BRCA2 mutation carriers37,39 |
| Chemoprevention for breast cancer | None40 | Women at increased risk for breast cancer as defined by the Gail model and low risk for complications: tamoxifen preventive medication40 |
| Prophylactic mastectomy and oophorectomy | None | Women with ≥ 2 first-degree relatives with ovarian cancer: offer prophylactic oophorectomy after completion of childbearing or at age 35 y39 |
* Numbers in parentheses are reference citations.
USPSTF Program Office |
