Tailored Screening

The Breast Health & Wellness Center is committed to breast cancer prevention. We believe, the first step in breast cancer prevention is to identify women who may be at higher risk than a general population woman to develop breast cancer.

A routine part of your visit at the Breast Health & Wellness Center will include an Individual Risk Assessment. Our nurses will enter your personal data and comprehensive family history into the Mastery of Breast Surgery Program through the American Society of Breast Surgeons.   This will allow immediate calculation of three risk models : Gail Risk Model, Tyrer-Cuzick Risk Model and Claus Risk Model.

This information identifies your lifetime risk for the development of breast cancer. This information, as well as the comprehensive breast exam that will be performed during this consultation as well as review of your imaging studies, will allow Dr. App to determine your level of risk to develop breast cancer. You will then be catergorized into the following:

Low Risk

Intermediate Risk

High Risk


A Tailored Screening Program will then be provided to you based on your individual risk.


Example of Low Risk:

For example, a woman with fatty breast tissue (non-dense) and no family history of breast cancer has a low risk and will be recommended:

Annual screening digital mammography

Monthly self breast exams

Annual breast exam by Physician


Example of Intermediate Risk Woman:

This may be a woman who had her first baby after age 35 or has never had children, her breast tissue is mildly dense, she may have had a previous biopsy revealing atypical cells and she has a some family history of breast cancer.


Her tailored screening program may include:

Annual screening digital mammography, may consider 3-D mammogram (Tomosynthesis)

Monthly self breast exams

Annual breast exam by Physician

Screening breast US may be considered

These patients do not typically meet insurance criteria for standard high risk screening breast MRI, however may be a candidate for and an abbreviated form of screening breast MRI (cash pay)


Example of High Risk Woman:

  • This may be a woman who has a strong family history of breast cancer, has dense breast tissue, has required previous breast biopsies showing atypical cells.
  • Woman who has had previous mantle radiation for childhood Hodgkin’s Lymphoma
  • Woman with Neurofibromatosis
  • Woman with any of the following genetic mutations:

BRCA 1 , BRCA 2                      ATM                                     PALB2

MMR                                         CHEK2

APC                                            BARD 1

PTEN                                         BRIP1

SMAD4                                     RAD51C, RAD51D

STK11                                        NBN


Example of High Risk Tailored Screening Program


Monthly self breast exams

Annual breast exam by Physician

Annual screening 3-D mammogram (Tomosynthesis)

Annual High Risk Screening Breast MRI

Breast Ultrasound as indicated


  • The message is, all women do not have the same risk for the development of breast cancer and The Breast Health & Wellness Center can assist in identification of your personal risk for the development of breast cancer and provide you with the Tailored Screening Program you deserve!


For more information please follow this link to the breast360.org/en/topics/2015/10/23/breast-cancer-screening-101/