Two Onc Docs Breast Cancer Screening, Prevention & Intro 2025 UPDATE
Oct 6, 2025
October marks Breast Cancer Awareness Month, making this a timely discussion. Key topics include breast cancer risk factors, when to get genetic testing, and screening recommendations for high-risk individuals. They delve into the management of LCIS and DCIS, detailing treatment options like mastectomy versus lumpectomy. Insights on chemoprevention, tamoxifen's side effects, and the challenges of rare breast histologies are also explored. Plus, learn the basics of staging and when axillary dissection is necessary.
AI Snips
Chapters
Transcript
Episode notes
Genetic Versus Sporadic Breast Cancer Risks
- Most breast cancers are sporadic but specific germline genes (BRCA1/2, PALB2, TP53, PTEN, ATM, CHEK2, CDH1) markedly increase risk.
- BRCA1 carries higher ovarian and contralateral breast cancer risk than BRCA2 and CDH1 raises lobular cancer and diffuse gastric cancer risk.
Who Should Get Genetic Testing
- Offer genetic testing for women with breast cancer before age 65, triple-negative disease, or family/personal history of ovarian, male breast, metastatic prostate, or pancreatic cancer.
- Consider universal testing for all patients with breast cancer as some experts recommend.
Screening Ages And Risk-Based MRI
- Start screening discussions at age 40 and recommend biennial or annual mammography based on risk and guidelines; screen ages 50–74 universally.
- Use risk models (Gail, IBIS) to start earlier imaging or add MRI when five-year or lifetime risk thresholds are met.