The most important risk factors for breast cancer are genetic predisposition, exposure to oestrogens, ionising radiation, low parity and a history of atypical hyperplasia. The Western-style diet, obesity and the consumption of alcohol also contribute to the risk of developing a breast cancer. About a quarter of all breast cancers occur at an age before 50 and less than 5% of them occur before the age of 35 years.
The European Guidelines in breast cancer screening and diagnosis recommend performance parameters that should be monitored in screening programmes. Mammography screening is recommended every two years as it shows the greatest mortality reduction benefits in the age group of 50-69 years. A recent breast cancer screening report from the International Agency for Research and Cancer concluded that the evidence suggests that the effectiveness of mammography screening in women aged 40-49 years is limited. In case of familial breast cancer with or without BRCA mutations, annual screening with MRI and mammography can diagnose the disease at an early stage as compared to diagnosis through screening alone. The guideline recommends MRI with mammography starting 10 years younger than the youngest case in the family. The evidences about ultrasound do not help the experts reach at a consensus.
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