title: Personalized assessment and management of women at risk for breast cancer in North America.
abstract: Many women at increased risk for breast cancer would benefit from referral for genetic testing, enhanced screening, preventive therapy or risk-reducing surgery. We present a visual model and a step-wise approach to assist with a personalized risk stratification and management of these women. We present current recommendations with respect to lifestyle behaviors and mammographic screening, and we review the current evidence regarding enhanced screening and risk-reducing therapies. We discuss the usefulness of three risk-assessment tools in determining whether a woman qualifies for genetic testing, enhanced screening or preventive therapy and present four cases to demonstrate the usefulness of this approach in the clinical setting.
authors.affiliation: Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Pruthi
authors.forename: Ruth
authors.initials: R
authors.lastname: Heisey
authors.forename: Therese
authors.initials: T
authors.lastname: Bevers
mesh_terms: D047072:Aromatase Inhibitors / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008408:Mastectomy / Q000379:methods; D009656:North America; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage
chemical_list: D047072:Aromatase Inhibitors; D020845:Selective Estrogen Receptor Modulators
keywords: breast cancer; genetic testing; intensive screening; preventive therapy; risk assessment; risk calculators; risk-reducing surgery