The woman at increased risk for breast cancer: evaluation and management strategies.

Increased understanding of risk factors for breast cancer, especially the identification of genes associated with a predisposition to breast cancer, has focused attention on the issue of breast cancer prevention. At present, the only clinically available method of breast cancer prevention is prophylactic mastectomy. However, there are no absolute indications for its use, and it is not often appropriate in relation to actual risk for disease. This article reviews what is known about major breast cancer risk factors, reviews the available data on prophylactic mastectomy, and discusses current strategies for the management of the woman at increased risk for breast cancer.