Genetic Screening

Risk stratification based upon family history and established risk factors is essential. There are models such as the GAIL model which can calculate risk based upon age, age of menarche, age first live birth, # first degree relatives with breast cancer, hx breast biopsies and finding of atypia. For patients determined to be at high risk, genetic counseling to discuss possible benefit of BRCA testing is important. Surveillance may include self, exam, clinical breast exam, mammography, ultrasound and MRI depending on the level of risk.