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Breast cancer is the most common form of cancer and the second most common cause of cancer death in women. Recently recognized risk factors include alcohol use and increased breast density, in addition to the long-recognized familial, age-related, and reproductive risk factors. Clinical calculators to estimate breast cancer risk are widely available and are helpful but do not consider more recently identified risk factors or risk associated with specific genetic abnormalities. Women at high risk may consider chemoprevention, which decreases the risk for breast cancer by 30% to 50%. Women should be considered for breast cancer screening with clinical strategies that vary by age and degree of breast cancer risk. Mammography remains the mainstay of breast cancer screening. Women should consider the risks and benefits of screening at age 40 to 49 years. Women of average life expectancy should be involved in a screening program from age 50 to 74 years, and some women may benefit from continuing screening to an older age. Mammographic screening at a 2-year interval conveys most of the benefit of annual mammography. Screening mammography remains underused, even when using a standard of every 2 years.
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