Women at high risk for breast cancer: A primary care perspective

Breast cancer is both a biologically and psychologically devastating disease. For women at high risk, there exists an enormous and often confusing array of recommendations for optimal care. The obstetrician/gynecologist has an opportunity an d responsibility for assessing actual risk, determining a care strategy, and addressing the patient's understandable concerns. This review highlights biological, psychological, and sociologic topics that are important in addressing women at high risk for breast cancer. The authors discuss current estimates used for calculating breast cancer risk, as well as a means of presenting risk estimates in a manner that is useful to patients. The authors review both the current options available for decreasing breast cancer risk and potential treatments under study. By understanding the impact of breast cancer risk, the informed obstetrician/gynecologist can be ideally suited to coordinate the care of women at high risk in a rational and compassionate fashion.