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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 Li-Fraumeni syndrome (TP53 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 20
  • Annual breast MRI with contrast or mammogram beginning at age 20 (MRI preferred) or at the age of earliest breast cancer diagnosis if there is a history of breast cancer before age 20 in family
  • Annual breast MRI and mammogram beginning at 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

Additional cancer screening for men and women

  • Annual physical exam
  • Annual skin cancer screening starting at age 18
  • Annual whole body MRI
  • Annual brain scan (either as part of whole body MRI or separately)
  • Consider colonoscopy every 2-5 years beginning at age 25
  • Additional screening based on family cancer history
  • Alert pediatricians to the mutation in the family and the associated risk of childhood cancers
  • Provide education regarding signs and symptoms of cancer
  • Address psychosocial, social and quality of life aspects of the complext management of Li-Fraumeni Syndrome

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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