Tests and frequency of testing for women at very high risk
Updated 5 February 2025
Applies to England
© Crown copyright 2025
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Breast cancer (BRCA) gene carriers and equivalent risks
This group of women at very high genetic risk of developing breast cancer includes:
- BRCA1 carriers
- BRCA2 carriers
- risk equivalent to BRCA carriers not tested [footnote 1], but have a first degree relative who has a BRCA1 or BRCA2 genetic mutation
- women who have a mutation in another high-risk gene including [footnote 2]:
- PALB2
- PTEN
- STK11
- CDH1 (E-Cadherin)
| Age | Test | Frequency of testing |
|---|---|---|
| 25 to 29 (see note) | Magnetic resonance imaging (MRI) | Annual |
| 30 to 39 | MRI | Annual |
| 40 to 50 | MRI and mammography | Annual |
| 51 to under 71 | Mammography with or without MRI (based on review of background density from 50 years) | Annual |
Note: To qualify for screening under 30 years, women must also have an 8%, 10-year risk at the age when entered (when aged 25 to 29 years). This applies to BRCA carriers and PALB2 only.
Women with TP53 (Li-Fraumeni) syndrome
| Age | Test | Frequency of testing |
|---|---|---|
| 20 to under 71 | MRI | Annual |
No mammography tests for this group of women.
Women with A-T homozygotes
| Age | Test | Frequency of testing |
|---|---|---|
| 25 to under 71 | MRI | Annual |
No mammography tests for this group of women.
Women who have had radiotherapy to breast tissue
Females irradiated between ages 0 and 9 years
Testing is not applicable to these females.
Females irradiated between ages of 10 and 19
| Age | Test | Frequency of testing |
|---|---|---|
| 25 to 29 (see note) | MRI | Annual |
| 30 to 39 | MRI | Annual |
| 40 to 50 | MRI and mammography | Annual |
| 51 to under 71 | Mammography with or without MRI (based on review of background density from 50 years) | Annual |
Note: Surveillance starts at 25 or 8 years after first irradiation, whichever is the later.
Females irradiated between ages of 20 and 35
| Age | Test | Frequency of testing |
|---|---|---|
| 30 to 39 (see note) | MRI | Annual |
| 40 to 50 | MRI and mammography | Annual |
| 51 to under 71 | Mammography with or without MRI (based on review of background density from 50 years) | Annual |
Note: Surveillance starts at 30 or 8 years after first irradiation, whichever is the later.