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Breast cancer - managing family history - Management
Basis for recommendation

  • These recommendations are based on the guideline from the National Institute for Health and Clinical Excellence (NICE) [NICE, 2006a].

Recommendations for magnetic resonance imaging surveillance (MRI)

  • These recommendations are based on recent evidence showing that [NICE, 2006a]:
    • MRI increases the sensitivity of breast cancer screening, which means that there is the potential to detect breast cancer at an early stage.
    • MRI is more effective than mammography in screening younger women, because of differences in breast tissue density.
    • Therefore, MRI surveillance is now recommended for younger women who are at high risk of breast cancer and who meet certain criteria.

Risk-reduction surgery

  • NICE reviewed the available evidence and concluded that [McIntosh et al, 2004]:
    • Mastectomy and/or oophorectomy reduce the risk of breast cancer in women with a family history of breast cancer or with BRCA1 and BRCA2 mutations, but surgery is appropriate for only a small proportion of women from high-risk families.
    • Risk-reducing total mastectomy is associated with fairly high levels of satisfaction and a reduction in both anxiety and psychological morbidity. It will not prevent the development of all breast cancers. There is inconsistent evidence about psychosocial outcomes after oophorectomy.

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