GENetic Risk Estimation of Breast Cancer Prior to Decisions on Preventive Therapy Uptake, Risk Reducing Surgery or Intensive Imaging Surveillance

Inclusion Criteria:

Women > 35 years old and < 75 years old

Women with any of the following:

A. A NCI-BCRAT 5 year risk of ≥ 3% which corresponds to the level in which there is moderate evidence of treatment benefit outweighing risk according to the US Preventative Services Task Force (32); or B. IBIS (Tyrer-Cuzik) score for the 10 year risk of breast cancer of ≥8% 43 C. Biopsy proven atypical ductal hyperplasia or atypical lobular hyperplasia. D. History of lobular carcinoma in situ E. BRCA mutation carrier or other hereditary breast mutation carrier

Able to participate in all aspects of the study
Understand and signed the study informed consent

Exclusion Criteria:

Women whose BCRAT falls below the threshold (<3 % 5 year risk) of moderate benefit according to the US Preventative Task Force AND Women whose IBIS score is <8% for the 10 year risk
Women with known contra-indications to Tamoxifen, raloxifene ,exemestane, or anastrazole
Current or prior use of Tamoxifen, raloxifene, exemestane or anastrazole
Unable to give informed consent
Prior history of invasive breast cancer, ductal carcinoma in situ or other breast cancers
At high risk due to prior radiation therapy to the chest
Women who are pregnant or breastfeeding
Prior risk reducing or prophylactic mastectomy