Table 1 Primary and secondary prevention for women at risk for inherited breast or breast-ovarian cancer

   1. Annual clinical mammography and MRI from the age of 30 years onwards. For demonstrated mutation carriers there should be no upper age limit. Healthy at-risk women based on family history alone will have low probability for being mutation carriers over 70 years of age.

   2. Prophylactic mastectomy should be an option, but may not be actively advocated until the benefit of MRI is known.

   3. Prophylactic oophorectomy over 35 years of age when family is completed.

BRCA2 mutation carriers (by testing or assumed by family history)

   1. As for BRCA1 mutation carriers, but oophorectomy may not be indicated before 40 years of age.

   2. There is no consensus on practical use, but anti-oestrogens may prevent oestrogen receptor-positive tumours.

Familial breast cancer (high breast cancer risk according to family history not including ovarian cancer)

   1. Annual clinical mammography from the age of 30 years onwards.

   2. There is no consensus on practical use, but anti-oestrogens may prevent oestrogen receptor-positive tumours.