1. Jump to first page First pregnancy after age 30 (RR 1.48). BMI >29 (RR 1.48). Being a college graduate, independent of OB-GYN history (RR 1.36). (Collaborative Group Lancet 1997; 350:1047-1059.) Alcohol use of over 5 g/day (RR 1.16). Being left handed (RR 2.0). The use of Prempro 0.615/2.5 in the one arm of WHI (RR of invasive breast cancer by year 4 was 1.73; HR = overall risk 1.24; CI = 1.00-1.56). Breast Cancer Risk Factors

2. Jump to first page High Risk for Breast Cancer nFamily history of breast cancer should be 1 st degree relatives. nA history of fibrocystic breast disease particularly with multiple breast biopsies and particularly in a woman with atypical hyperplasia. nPersonal history of breast or ovarian cancer. nAshkenazi Jewish heritage. nA biopsy in the past of lobular carcinoma in situ (LCIS). n5-year calculated risk factor of breast CA diagnosis  1.7%. nAll of the above.

3. Jump to first page Breast Cancer Risk Into Perspective n Reduction in breast cancer risk: u Breast feeding for over 7 months (RR 0.70). u Moderate exercise risk reduction (RR 0.70). u 1 st full-term pregnancy under age 20 (RR 0.60).

4. Jump to first page Tools for Breast Cancer Detection n Monthly Self Breast Exam n Periodic physician breast exam n Mammography/ultrasound n MRI n Genetic risk assessment u BRCA1/BRCA2 n Ductal Lavage

5. Jump to first page Ductal Lavage

6. Jump to first page Ductal Lavage

7. Jump to first page Ductal Lavage

8. Jump to first page Ductal Lavage n Reproducibility of cytologic interpretation n Relationship of cytologic vs histologic atypia n Integration into clinical risk assessment n Role as diagnostic tool n False (-) rate n Further evaluation of abnormal result