What are the recommended surveillance strategies for patients with a family history of hereditary breast and ovarian cancer syndrome?

For patients with a family history of hereditary breast and ovarian cancer syndrome, surveillance strategies depend on their age and estimated risk level.

Women at very high risk (lifetime risk of 40% or greater) are managed by the NHS Breast Screening Programme, which includes annual mammography from age 30 to 69 and annual MRI surveillance from age 30 to 49, especially if they have a known BRCA1, BRCA2, or TP53 mutation ¹.

Women at high risk with a known BRCA1 or BRCA2 mutation should be offered annual mammography and MRI from age 30 to 49, with continued mammography as part of the population screening from age 50 onwards, and MRI surveillance considered for women aged 50 to 69 if they have dense breasts ¹.

For women with a moderate risk (lifetime risk of 30% or greater but less than 40%), annual mammography is recommended from age 40 to 49, with MRI considered for those with a greater than 30% probability of being a BRCA or TP53 carrier, especially if they are aged 30 to 49 ¹.

Surveillance should be reviewed if family history changes or new genetic information becomes available ¹.