Table 11.

Guideline Recommendations for breast cancer.

Breast cancer
No	Recommendations	Strength
1	Despite there being no evidence of outcome benefits from clinical assessment, education about breast self-examination probably should be conducted as it raises awareness and engagement with clinical centres.	weak
2	Screening with annual breast MRI should be the primary approach, mammography being second best alternative when MRI is not available. Age at commencement of screening in NF1 should begin as soon after the age of 30 years as feasible in the local health system context.	moderate
3	Screening should continue until 50 years after which time, screening should be according to national guidelines for the general population.	moderate
4	Risk-reducing bilateral mastectomy for woman without breast cancer should not be performed in patients with NF1 unless there are substantial additional risk factors such as a family history of breast cancer that would elevate risk into a high-risk category.	moderate

Note. MRI = magnetic resonance imaging; NF1 = Neurofibromatosis type 1.