General screening
· 50 to 70 invited every three years
· > 70 GP can refer to local screening unit
Primary care management only
If the FHx shows only one 1st degree or 2nd degree relative diagnosed with breast cancer @ > 40, provided that none of the following is present in FHx:
· Bilateral breast cancer
· Male breast cancer
· Ovarian cancer
· Jewish ancestry
· Sarcoma in a relative younger than age 45y
· Glioma or childhood adrenal cortical carcinomas
· Complicated patterns of multiple cancers at a young age
· Paternal history of breast cancer (two or more relatives on the father’s side of the family)
Refer to the breast service [for initial screening, then if needed to the genetics services]
· One 1st degree F relative diagnosed with breast cancer at < 40y
· One 1st degree M relative diagnosed with breast cancer at any age
· One 1st relative with bilateral breast cancer where the first primary was diagnosed at younger than age < 50y
· Two 1st degree relatives, or one 1st degree and one 2nd relative, diagnosed with breast cancer at any age
· One 1st degree or 2nd degree relative diagnosed with breast cancer at any age and one 1st degree or 2nd degree relative diagnosed with ovarian cancer at any age [one of these should be a 1st degree relative]
· Three 1st degree or 2nd degree relatives diagnosed with breast cancer at any age
Degrees
· 1st – Relatives share half of their genes with the person – [parents, brother, sister, or child]
· 2nd – Relatives shares about one quarter of their genes with the person – [uncle, aunt, nephew, niece, grandparent, grandchild or half-sibling]
· 3rd – Relatives share about one eighth of their genes with the person – [first cousin, great-grandparent or great-grandchild]
Detailed information: http://www.patient.co.uk/doctor/familial-breast-cancer