Breast cancer screening resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2], Rim Halaby, M.D. [3]


Breast cancer screening is an attempt to find unsuspected cancers. The most common screening methods include self and clinical breast exams, x-ray mammography, breast magnetic resonance imaging (MRI), ultrasound, and genetic testing.

BRCA Testing

Approach to Genetic Testing

Assess women with:
❑ No previous diagnosis with BRCA related cancer, and
❑ Absence of signs and symptoms of any BRCA related cancer
Risk assessment: is ANY of the following history factors present?

❑ Family members with breast, ovarian, tubal or peritoneal cancer
❑ Breast cancer diagnosis before age of 50 years
❑ History of bilateral breast cancer
❑ Presence of both breast and ovarian cancer
❑ Breast cancer in one or more male family members
❑ Multiple breast cancer cases in the family
❑ One or more family members with two primary types of BRCA related cancers
❑ Ashkenazi Jewish ethnicity

High risk of potentially harmful BRCA mutation based on screening?
Genetic counseling
❑ Risk assessment for presence of potential BRCA mutation
❑ Educating patients about the possible genetic testing results
❑ Risk assessment of family members to identify suitable candidates for genetic testing
❑ Discussion about risk reducing interventions
❑ Post-test counseling
BRCA mutation genetic testing

Algorithm based on the 2013 US Preventive Services Task Force recommendation statement.[1]


  1. Moyer VA (2013). "Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer in Women: U.S. Preventive Services Task Force Recommendation Statement". Ann Intern Med. doi:10.7326/M13-2747. PMID 24366376.