Table 3.

NCCN Li-Fraumeni screening guidelines.

Breast self-exam training and education starting at age 18 years

Clinical breast exam, every 6–12 months, starting at age 20–25 years or 5–10 years before the earliest known breast cancer in the family (whichever comes first).

Annual mammogram or breast MRI starting at age 20–25 years or individualized based upon the earliest age of onset in the family.

Annual comprehensive physical exam; include careful skin and neurologic examinations

Consider colonoscopy every 2–5 years starting no later than age 25 years.

Targeted surveillance based on individual family histories

Discuss options to participate in novel screening approaches using technologies such as PET, abdominal ultrasound, and brain MRI within clinical trials when possible.

Recommend genetic counseling and consideration of genetic testing for at-risk relatives.