|Type of risk||Points||Score|
|Family history (age of diagnosis)|
|Mother (under 50)||20|
|Mother (over 50)||12|
|Sister (under 50)||20|
|Sister (over 50)||12|
|More than one aunt, cousin, or grandmother||5|
|One aunt, cousin, or grandmother||3|
|You have had a previous breast cancer||25|
|You have had breast surgery showing atypia||15|
|You have had multiple benign biopsies||4|
|You have had a benign breast biopsy||3|
|You have had a previous cancer of the ovary or uterus||2|
|You have dense breast tissue||4|
|You are 30 years old or older and have never had a child||2|
|You had your first child at age 30 or older||2|
|Menstruation began at age 11 or younger||2|
|Menopause occurred at 55 or older||2|
|Menopause occurred between 46 and 54||1|
|You are overweight, with extra weight in the upper body (apple shape)||2|
|You are overweight, with extra weight in the thighs and buttocks (pear shape)||1|
|You eat a high fat diet (fried foods, deli, meat, cheese)||1|
|You are presently taking or have taken female estrogen and progesterone (PREMPRO®) for more than 5 years||2|
|You had natural menopause and have taken estrogen and progesterone (PREMPRO®) for more than 10 years||3|
Your present risk of developing breast cancer may be estimated by comparing your total score to the chart below. However, this is only an approximate value, and if you develop any symptoms you should consult your doctor immediately.
0-10 Average Risk
11-19 Moderate Risk
20-29 High Risk
30+ Highest Risk
WOMEN AT AVERAGE RISK:
Women at average risk need yearly mammography starting at age 40 (baseline at age 35), and yearly clinical breast exam.
MODERATE INCREASE IN RISK:
See recommendations above. In addition, we recommend a clinical breast exam with a breast specialist, which should include a discussion of breast cancer prevention strategies.
You need all of the above plus a thorough evaluation of your family history and possible genetic testing for genetic mutations. The benefits and risks of new drugs to reduce breast cancer risk should be reviewed. Increased surveillance with more frequent breast exams and advanced breast imaging tests (such as MRI) should be considered.
Women at highest risk for breast cancer usually have a very strong family history of breast and ovarian cancer and can test positive for a genetic mutation. They need to avail themselves to all risk reduction strategies. These women should be under the care of a surgeon specializing in breast disease, who can oversee an intensive an individualized screening program.