Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer

Context

Familial breast cancer typically occurs in people with an unusually high number of family members affected by breast, ovarian or a related cancer. If more cases of breast, ovarian or a related cancer are seen in a family than would be expected by chance alone, this can be a sign that genes have caused or contributed to its development. Breast cancer in people who have a family history of breast, ovarian or a related cancer may need different management from that in people without a family history of these cancers. This is because of differences in the future risk of developing contralateral breast cancer.

The risk of developing breast cancer depends on the:

This guideline describes the classification and care of people at risk of familial breast cancer. It also covers people with a diagnosis of breast cancer and a family history of breast, ovarian or a related cancer. It includes recommendations on genetic testing thresholds, surveillance and risk reduction and treatment strategies. These areas are not covered by the NICE guideline on early and locally advanced breast cancer.

We have updated recommendations on chemoprevention for women with no personal history of breast cancer and have added a new recommendation on genetic testing for women with triple negative breast cancer but no family history.