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Table 3 Management program for men and woman with CS from the National Comprehensive Cancer Network[30]

From: Hamartomatous polyposis syndromes: A review

Woman
Breast awareness starting at age 18 y
Clinical breast exam, every 6–12 month, starting at age 25 y or 5–10 y before the earliest known breast cancer in the family
Annual mammography and breast MRI screening starting at age 30–35 y or individualized based on earliest age of onset in family
For endometrial cancer screening, encourage patient education and prompt response to symptoms and participation in a clinical trial to determine the effectiveness or necessity of screening modalities
Discuss risk-reducing mastectomy and hysterectomy and counsel regarding degree of protection, extent of cancer risk and reconstruction options
Address psychosocial, social, and quality-of-life aspects of undergoing risk-reducing mastectomy and/or hysterectomy
Men and Woman
Annual comprehensive physical exam starting at age 18 y or 5 y before the youngest age of diagnosis of a component cancer in the family (whichever comes first), with particular attention to breast and thyroid exam
Annual thyroid starting at age 18 y or 5-10 y before the earliest known thyroid cancer in the family, whichever is earlier
Colonoscopy, starting at age 35 y, then every 5 y or more frequently if patient is symptomatic or polyps found
Consider renal ultrasound starting at age 40 y, then every 1-2 y
Dermatological management may be indicated for some patients
Consider psychomotor assessment in children at diagnosis and brain MRI if there are symptoms
Education regarding the signs and symptoms of cancer
  1. Adapted with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines(r)) for Genetic/Familial High-Risk Assessment: Breast and Ovarian V.1.2014. (c) 2014 National Comprehensive Cancer Network, Inc. All rights reserved. The NCCN Guidelines(r) and illustrations herein may not be reproduced in any form for any purpose without the express written permission of the NCCN. To view the most recent and complete version of the NCCN Guidelines, go online to NCCN.org. NATIONAL COMPREHENSIVE CANCER NETWORK(r), NCCN(r), NCCN GUIDELINES(r), and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.