Because of the increased risk for breast cancer, women should have increased breast cancer surveillance. This includes performing monthly breast self-examination, getting a clinical breast examination every six to 12 months beginning at 21 years of age, in addition to annual mammograms beginning at age 30 to 35 years of age. Some young women have dense breast tissue that can limit the detection of early breast cancer associated with Bannayan-Riley-Ruvalcaba syndrome. Prophylactic mastectomy is an option available to women for whom screening is not effective or who have had multiple breast biopsies. Men also have an increased risk for breast cancer and because of this should perform a monthly breast self-exam beginning at age 21 years. Women should also receive endometrial cancer screening beginning at age 30 to 35 years. Pre-menopausal women should have a blind-repel biopsy annually.

Post-menopausal women should have an annual transvaginal ultrasound.
Both men and women should receive annual thyroid cancer surveillance that includes a baseline ultrasound of the thyroid during adolescence. After the baseline evaluation is complete, annual thyroid palpation to look for any changes is recommended. Because thyroid nodules can be a common feature, experienced endocrinologists need to evaluate any thyroid nodules to determine if they require additional follow-up, such as a biopsy.

Skin and colon cancer screenings should also be done regularly. There is no clearly increased risk for colorectal cancer for patients with Bannayan-Riley-Ruvalcaba syndrome, but a baseline colonoscopy should be done at age 50 years. If this screen shows only hamartomas (a common feature) then annual fecal occult blood screenings and sigmoidoscopies every three to five years are needed. Annual urinalysis to check for any renal abnormalities is also recommended.

Check Yourself. Are you getting the screenings you need?

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