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Description of the Evidence

    Table 1. Risk of Breast Cancer Diagnosisa

    Current Age (in Years)Risk in Next 10 YearsLifetime Risk of a Breast Cancer Diagnosis
    a Adapted from Altekruse et al.[2]
    301 in 2501 in 8
    401 in 711 in 9
    501 in 421 in 9
    601 in 291 in 11
    701 in 271 in 15

    Age

    The incidence of breast cancer increases with a woman's age. As shown in Table 1, a 60-year-old woman has a higher risk of being diagnosed with breast cancer in the next 10 years than does a 40-year-old woman.

    The cumulative lifetime incidence decreases with advancing age because the longer a woman lives without a breast cancer diagnosis, the lower her lifetime risk compared to a younger woman who might develop breast cancer at a younger or older age. The commonly quoted risk of one in eight women who will be diagnosed with breast cancer is based on lifetime risk of a diagnosis (not death) starting from birth and does not account for the woman's current age.[2]

    Breast cancer mortality increases with age. For a 40-year-old woman without a breast cancer diagnosis, the chance of dying from breast cancer within the next 10 years is extremely small, but for a woman older than 65, it is about 1%. For a woman older than 70, the risk of dying of breast cancer is even higher, but the risk of dying of any cause is higher yet.[5]

    Personal history of breast cancer

    Women with a personal history of invasive breast cancer, DCIS, or lobular carcinomain situ also have an increased risk of being diagnosed with a new primary breast cancer.[6] Recommendations for subsequent mammograms vary, but evidence for various strategies is scant.

    Prior radiation therapy

    Women treated with thoracic radiation before the age of 30 years have a 1% annual risk of breast cancer, starting 8 years after the irradiation and for the rest of their lives.[7,8] Annual screening with magnetic resonance imaging has been proposed in such women, beginning 8 years after treatment or by age 25 years, whichever is later.[9] Because this population is small, there are no studies to confirm the benefit of this recommendation.

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