Current comprehensive assessment and management of women at increased risk for breast cancer

Am J Surg. 2004 Mar;187(3):349-62. doi: 10.1016/j.amjsurg.2003.12.025.


The potential for reducing the risk of breast cancer through selective estrogen receptor modulators, aromatase inhibitors, and surgery has generated interest in the use of quantitative models of risk assessment. With the addition of ductal lavage cytology to traditional epidemiologic risk factors, a discovery of cellular atypia can result in refinement of assigned risk values, while simultaneously optimizing patient selection for selective estrogen receptor modulators utilization. In view of increasing complexity in this arena, a Risk Assessment Working Group was formed to outline management strategies for the patient at an elevated risk for the development of breast cancer. No longer a statistical exercise, quantitative risk assessment is part of basic breast care and comprehensive management includes a discussion of the following: ductal lavage for improved risk stratification, multiple options for risk reduction, and high risk surveillance strategies that might incorporate investigational imaging protocols.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Biopsy, Needle
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Female
  • Humans
  • Immunohistochemistry
  • Incidence
  • Mastectomy / methods
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy, Adjuvant
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome
  • United States / epidemiology


  • Antineoplastic Agents, Hormonal