••• CHAPTER 65^ ACOG Screening Guidelines Since 2007^655
❍ Who should receive MRI screening modality?
Patients with a 20% lifetime risk of breast cancer.
Personal history of breast and ovarian cancer.
Personal history of ovarian cancer and a close relative with ovarian cancer or premenopausal breast cancer.
Personal history of ovarian cancer with an Ashkenazi Jewish ancestry.
Personal history of breast cancer at the age of 50 years or younger with a close relative with ovarian cancer or male
breast cancer.
Personal history of breast cancer at the age of 40 years or younger and Ashkenazi Jewish ancestry.
Personal history of BRAC1 and BRAC2 or a close relative with BRAC positive testing.
Personal history of Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome or one of
these syndromes in a first-degree relative.
Personal history of radiation to the chest from 10 years old to 30 years old.
(Close relative is defined as a first- or second-degree relative)
❍ What is the difference between breast self-examination and breast self-awareness?
Breast self-examination is a monthly breast examination performed by the patient, and breast self-awareness is
becoming familiar with ones breast so that changes can be detected.
❍ Why is breast self-awareness preferred by ACOG over breast self-examination?
The Shanghai Breast Self-Examination Study enrolled 266,000 women aged 29 to 72 and showed no change in
breast cancer deaths for patients who performed breast examinations versus those who did not.
❍ How many women are the first to identify breast cancer in themselves?
Up to 70% of women <50 years old and 50% of women >50 years old.
❍ What is the significance of clinical breast examinations?
Clinicians detected 5 cases of cancer per 1000 patients examined and also detected 7.4 cases of cancer
per 1000 patients screened when mammography was normal.
❍ What is the frequency of clinical breast examination?
For those aged 20 to 39 examine every 1 to 3 years and those over 40 should be examined yearly.
❍ What is the incidence of breast cancer in women aged 40 to 49?
1 in 69.
❍ What is the incidence of breast cancer in women aged 50 to 5?
1 in 38.
❍ How many women <50 years are diagnosed with breast cancer per year?
Approximately 50,000.