Risk Assessment
If an asymptomatic woman has negative findings on physical examination, the next decision point is based on risk stratification. Women can be stratified into 2 basic risk categories for the purpose of screening recommendations: normal and increased risk. The increased risk category consists of 6 groups: 1) women who have undergone previous therapeutic thoracic irradiation or mantle irradiation; 2) women aged 35 years or older with a 5-year risk for invasive breast carcinoma of 1.7% or greater; 3) women with a lifetime risk for breast cancer greater than 20% based on models largely dependent on family history; 4) women with a strong family history or genetic predisposition; 5) women with lobular carcinoma in situ (LCIS) or atypical hyperplasia; and 6) women with a prior history of breast cancer