Procedures
Risk Assessment and surveillance
Understanding your personal breast cancer risk — and knowing what to do with that information — is one of the most valuable steps you can take for your long-term breast health. For some women, risk assessment provides reassurance that their risk is closer to average than they feared. For others, it identifies a genuinely elevated risk that warrants a structured surveillance program, genetic testing, or consideration of risk-reducing interventions.
At Breast & Surgical Oncology at The Poche Centre, risk assessment and surveillance is a well-established and important part of our practice. Our breast surgeons and breast physician assess personal and family history, review imaging and pathology, and work collaboratively with geneticists, medical oncologists, and radiologists to ensure every patient has a clearly defined, evidence-based plan for monitoring and managing their breast health.
The services we provide in this area are described in the sections below.
Assessment of Breast Cancer Risk and Screening Advice
A formal breast cancer risk assessment takes into account your personal history, family history, reproductive history, hormonal exposures, breast density, and any prior breast pathology to estimate your lifetime and ten-year risk of developing breast cancer. This assessment determines whether you fall into the average, moderately elevated, or high-risk category, which in turn guides the type and frequency of screening most appropriate for you. Many women who attend for risk assessment discover their risk is lower than they assumed; others are identified as having a level of risk that warrants a more structured approach than standard population screening alone.
Genetic Testing Where Indicated
For women whose personal or family history raises concern for an inherited predisposition to breast cancer, genetic counselling and, where appropriate, genetic testing is an important next step. Testing for mutations in genes including BRCA1, BRCA2, PALB2, and others can clarify risk significantly and directly inform screening, surveillance, and risk-reduction decisions — not only for the patient but for their blood relatives. Our team identifies patients who are likely to benefit from genetic assessment and can order genetic testing and/or coordinate referral to familial cancer services and clinical geneticists as part of an integrated risk management approach.
Assessment of Benign Breast Problems and Surveillance Advice
Not all breast conditions require treatment, but some warrant ongoing monitoring to ensure stability and to detect any change that might indicate a need for further assessment or intervention. Benign breast conditions that may be managed with active surveillance include small fibroadenomas, simple cysts, areas of fibrocystic change, and high-risk lesions such as atypical ductal hyperplasia or lobular carcinoma in situ identified on previous biopsy. Our breast physician provides clear, personalised surveillance plans for patients with benign breast conditions, with imaging schedules and review intervals tailored to the nature of the condition and the individual's overall risk profile.
High Risk Screening Assessment and Imaging Surveillance
Women identified as being at high risk of breast cancer — including those with a confirmed gene mutation, a very strong family history, or a personal history of high-risk breast lesions — require a more intensive and personalised surveillance program than standard population screening. This typically involves annual breast MRI and mammography commencing at a younger age than the national screening program, regular clinical breast examination, and coordinated review by a specialist multidisciplinary team. Our practice designs and coordinates individualised high-risk surveillance programs, working closely with specialist breast radiologists to ensure the most sensitive and appropriate imaging is used for each patient's circumstances.