Table 2.

Surveillance Protocol in Carriers of Germline disease-causing TP53 Variants (from reference 14).

Exam	Periodicity	Age to Start	Age to End	Condition
Clinical examination	Every six months	Birth	17 years
	Annual	18 years	-
Whole-Body MRI without gadolinium enhancement	Annual	Birth	-	TP53 variant conferring high cancer risk in childhood *
		18 years	-
Breast MRI	Annual	20 years	Until 65 years
Brain MRI **	Annual	Birth	18 years	TP53 variant conferring high cancer risk in childhood
		18 years	Until 50 years
Abdominal ultrasound	Every six months	Birth	Until 18 years
Urine steroids	Every six months	Birth	Until 18 years	When abdominal ultrasound does not allow a proper imaging of the adrenal glands
Colonoscopy	Every five years	18 years	-	Only if the carrier received abdominal radiotherapy for the treatment of a previous cancer or if there is a familial history of colorectal tumours suggestive of an increased genetic risk

* A germline disease-causing TP53 variant should be considered as “high risk” in childhood if the index case has developed a childhood cancer; or childhood cancers have been observed within the family, or this variant has already been detected in other families with childhood cancers, or this variant corresponds to a dominant-negative missense variant. ** The first scan should be conducted with I.V. Gadolinium enhancement; in children, brain MRI should alternate with the Whole-Body MRI, so that the brain is imaged at least every six months.