ABSTRACT

Breast cancer is the most common cancer among women, and its prevalence and associated mortality rate is increasing significantly in developing countries. Early diagnosis and proper management are necessary to reduce breast cancer morbidity and mortality, as evidenced by the positive impact of breast cancer screening in the United States and elsewhere. The Breast Health Global Initiative set forth breast health care guidelines for early detection, diagnosis and treatment in countries with limited resources. Breast cancer screening guidelines include more rigorous schedules for women, at high-risk of developing this disease and for whom the general guidelines for screening are not adequate for early detection of breast cancer. Identification of women at high-risk is, therefore, important. For individual patients, breast cancer risk evaluation may include assessment of personal and family history, genetic testing if indicated, and estimation of risk using population-based models, such as the Gail-model. Patients may be at high-risk due to modifiable or nonmodifiable risk factors, and risk scores may be assigned using the populationbased models. Patients with non-modifiable risk factors and high-risk scores require heightened surveillance, and some groups benefit from chemoprevention or risk reduction surgery. The aim of this review is to emphasize the importance of high-risk breast cancer clinics in assessing breast cancer risk, screening high-risk patients, and managing the therapy and continued follow up of women who are at high-risk of developing breast cancer in developed and developing countries.