1.Encourage regular breast self-examination;
2. Clinical breast examination or breast ultrasound once every 6-12 months;
3.Annual mammogram for those aged >35 years;
(1) Ultrasound or mammogram result of BIRADS grade 1: Screening as general risk women;
(2) Ultrasound or mammogram results of BIRADS grade 2-3.
(1) Cystic mass: perform fine needle aspiration cytology with benign results, clinical examination plus ultrasound every 6 months or mammography once a year; pathological examination when anomalous or malignant cells are seen on aspiration cytology.
②Solid masses: fine needle aspiration cytology, hollow core needle aspiration biopsy, minimally invasive excisional biopsy, and open surgical biopsy.
(③Other cases: review by ultrasonography in 6-12 months.
(3) Mammography BIRADS grade 4-5: domestic often also combined with ultrasonography to further assess the nature of the lesion and improve the diagnostic accuracy of breast disease. Fine needle aspiration cytology, hollow core needle aspiration biopsy, minimally invasive excisional biopsy, and open surgical biopsy are performed.
4. Annual breast MRI is recommended as a complementary test to mammography and clinical breast examination for those with a family history of breast cancer, and risk reduction strategies are considered: triamcinolone may be administered prophylactically.
5. For those with a history of breast cancer.
(1) Medical history and physical examination every 3-6 months for 5 years and annually thereafter. The examination includes: blood routine, liver function, liver ultrasound, chest X-ray, bone scan (X-ray or CT is required for symptomatic bone, long bone and weight-bearing bone scan abnormalities), positron beam scan (PET) if available, and ER/PR and HER-2 confirmation are recommended for those with unknown receptor status, originally negative or not over-expressed.
(2) Mammogram once a year (every 6-12 months after breast-conserving radiotherapy).
(3) Women taking triamcinolone acetonide need annual pelvic examinations if they have a uterus.
(4) Women taking aromatase inhibitors (AI) or women with ovarian failure secondary to treatment should have their bone density monitored.
(5) If a local recurrent lesion or systemic metastasis is found, treat accordingly.
6. Hemorrhagic nipple discharge.
(1) Lactoscopy, and surgical biopsy and treatment if there is a lesion on lactoductography.
(2) Ductoscopy/lactogram without lesions;
(1) Mammogram with BIRADS grade 0-3: 3 months follow-up, still have overflow or persistent overflow and undergo mammography again, surgical treatment if mammogram result is abnormal, liquid-based cytology (TCT) of milk duct rinsing fluid if mammogram result is not abnormal, surgical biopsy and treatment if test result is abnormal, further follow-up if test result is not abnormal.
② Mammography with BIRADS grade 4-5: surgical biopsy and treatment after a thorough examination and evaluation.