Medical management of women with inherited predisposition to breast cancer: indications and procedures for mammographic screening

Women identified or suspected as carriers of mutations in BRCA1 or BRCA2 su sceptibility genes have a high risk to develop an early breast cancer and t hus, require appropriate management. Some consensus guidelines were provide d for women at hereditary risk and two possible strategies of prevention ar e suggested: breast cancer screening and prophylactic surgery. We present t he French recommendations for breast cancer surveillance and discuss the ju stification, indications and modalities of mammographic screening. Screenin g by annual mammography is recommended from age 30 years in experienced cen ters, in association with semi-annual clinical breast examination from age 20 years, These recommendations apply to women who were identified as carri ers of a cancer-predisposing mutation of BRCA1 or BRCA2 genes. In families for whom any mutation of the two genes could be identified, the same modali ties apply also to women witb a higher probability than 25% of being a carr ier. We present here an illustration of the calculation of such probabiliti es from two example-pedigrees.