As a woman who is considered high risk, I assume I need to have more than an annual mammogram if I don’t elect to have surgery. What is recommended for women like me?

Doctors generally recommend close surveillance, which is the use of screening tests in an attempt to find cancer at an earlier, and often more curable, stage. Recommendations can vary somewhat depending on your situation, but the general guidelines for women at high risk for breast cancer may include:

  • Breast self-exam (BSE) training and regular monthly BSE starting at age 18
  • Clinical breast exam (physical examination by a health professional) every six months, starting at age 25
  • Annual mammogram and, in some cases, breast MRI (magnetic resonance imaging test). The age and frequency of screening is based on your personal risk assessment.

Although mammography is the standard screening tool for breast cancer, new research suggests that MRI actually may be a better screening tool for high-risk women. One drawback of MRI is that it appears to be more likely to return a false positive result—that is, to detect an apparent abnormality that leads to further testing, only to find it is not breast cancer. However, many experts are now recommending that high-risk women opt for breast cancer screening done with MRI.
You may wish to discuss this possibility with your doctor and find a facility with the expertise and equipment needed to screen for breast cancer in this way. You also should ask if he or she recommends close surveillance for ovarian cancer, which requires having regular blood and imaging tests.

Reviewed by Jill Stopfer, MS

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