This guideline covers care for people with a family history of breast, ovarian or another related (prostate or pancreatic) cancer. It aims to improve the long-term health of these families by describing strategies to reduce the risk of and promote early detection of breast cancer (including genetic testing and mammography). It also includes advice on treatments (tamoxifen, raloxifene) and surgery (mastectomy).
NICE has also produced a guideline on some of the tests and treatments for early and locally advanced breast cancer.
In November 2023, we removed the off-label warning for anastrozole in our recommendations on chemoprevention for women at moderate or high risk of breast cancer, in line with the MHRA licence variation.
For information on related topics, see our breast cancer summary page.
This guideline includes recommendations on:
- clinical significance of a family history of breast cancer
- information and support
- care of people in primary care
- care of people in secondary care and specialist genetic clinics
- genetic testing
- surveillance and strategies for early detection of breast cancer
- risk reduction and treatment strategies
Who is it for?
- Healthcare professionals
- People with a family history of breast, ovarian or a related (prostate or pancreatic) cancer and their carers
Guideline development process
This guideline updates and replaces NICE guideline CG41 (October 2006).
This guideline was previously called familial breast cancer: classification and care of people at risk of familial breast cancer and management of breast cancer and related risks in people with a family history of breast cancer.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.