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Case History

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Image not available. A 43-year-old woman who has been taking combined hormone replacement therapy (HRT) since the age of 38 for premature ovarian failure is concerned about breast cancer because her sister and a cousin have recently been diagnosed with breast cancer in their early 50s. Should she have mammography?

Is she at high risk of breast cancer?

What mammographic screening should be offered?

Does HRT affect mammography?

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Background

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Is she at high risk of breast cancer?

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Image not available. Concern about familial breast cancer is a common problem. In the United Kingdom (UK), the National Institute for Clinical Excellence (NICE) has produced clinical guidance for the classification and care of women at risk of familial breast cancer and the need for mammograms (Table 42.1).1

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Table Graphic Jump Location
Table 42.1Clinical guidance for the classification and care of women at risk of familial breast cancer
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This woman is not at increased risk of breast cancer since she has only one first-degree and one third-degree relative (her cousin) diagnosed with breast cancer after the age of 50 years. If she had other relatives with breast cancer increasing her risk, the following would be suggested. Current recommendations in the UK for mammographic surveillance of women at moderate risk or greater are that:

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  • It should not be available for women younger than ...

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