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Hereditary Cancer Info > Risk Management > Risk Management Guidelines

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Risk Management Guidelines

Learn about the steps that people at high risk for cancer can take to manage their risk and protect their health.

NCCN Guidelines for men and women with Cowden syndrome (PTEN Mutations)

Breast cancer screening for women

  • Learning to be aware of changes in breasts beginning at age 18
  • Clinical breast exam every 6-12 months beginning at age 25 or earlier based on family history
  • Annual breast MRI with contrast and mammogram beginning at age 30-35 or earlier if family history of breast cancer before age 30
  • Consider 3D mammography
  • Screening after age 75 should be considered on an individual basis

Breast cancer risk reduction for women

  • Discussion of risk-reducing mastectomy

Uterine cancer screening

  • Consider annual uterine biopsies and/or ultrasound beginning at age 30-35

Uterine cancer risk reduction

  • Consider hysterectomy after completion of childbearing

Recommended screening for both men and women 

  • Annual physical exam
  • Annual thyroid ultrasound
  • Colonoscopy every 5 years beginning age 35 or earlier based on family colon cancer history
  • Consider kidney ultrasound every 1-2 years starting at age 40

Reproductive options

  • For patients of reproductive age, advise about options for prenatal diagnosis and assisted reproduction including pre-implantation genetic diagnosis. 

Risk to relatives

  • Advise about possible inherited cancer risk to relatives, options for risk assessment, and management. 
  • Recommend genetic counseling and consideration of genetic testing for at-risk relatives. 

Updated 11/05/2018

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