Breast screening

Question 1

When is breast screening offered

Answer 1

Mammorgram every 3 years to women aged 50-70

Question 2

Downsides to screening

Answer 2

• Anxiety and stress
• Exposure to radiation, with a very small risk of causing breast cancer
• Missing cancer, leading to false reassurance
• Unnecessary further tests or treatment where findings would not have otherwise caused harm

Question 3

When are patients at high risk of breast cancer due to family history

Answer 3

First degree relative with breast cancer under 40 years
First degree male relative with breast cancer
First degree relative with bilateral breast cancer, first diagnosed under 50
Two first degree relatives with breast cancer

Question 4

What do patients require before genetic tests are performed

Answer 4

Genetic counselling
Pre-test counselling

Question 5

What is genetic and pre test counselling for

Answer 5

Discuss benefits and drawbacks of genetic testing eg implications for family and offspring

Question 6

What is offered to women at increased risk of breast cancer and when

Answer 6

Annual mammogram if increased risk
Age range depends on level of risk - start from 30 if high

Question 7

What can be offered to women medically if v high risk

Answer 7

Chemoprevention

Question 8

What chemoprevention is given before vs after menopause ot high risk breast cancer women

Answer 8

Premenopausal - tamoxifen
Postmenopausal - anastrazole

Question 9

Options for women at high risk

Answer 9

Chemoprevention
Annnual mammogram
Risk reducing bilateral mastectomy or oophorectomy