Proposed surveillance recommendations for PTEN hamartoma tumour syndrome
| Type of screening | When to begin | How often |
|---|---|---|
| In general | ||
| Complete physical exam and lesion assessment | At PHTS diagnosis | Annually |
| Patient education | Regarding signs and symptoms of cancer | |
| Psychological interventions | ||
| Brain | ||
| Psychomotor assessment | In children, at diagnosis | Annually |
| Brain MRI | Only if symptomatic | |
| Thyroid | ||
| Thyroid ultrasound | Age 10 years | Annually |
| Total thyroidectomy | If multinodular goitre or if surgery required | |
| Skin | ||
| Dermatological exam | At PHTS diagnosis | Annually |
| Vascular system | ||
| Clinical exam | At PHTS diagnosis | Annually |
| Surgery/embolisation | At vascular lesion diagnosis | |
| Breast in female | ||
| If mild breast dystrophy | ||
| Clinical breast exam and breast ultrasound | Age 25 years | Annually |
| Mammogram and breast MRI | Age 30 or 5 years before earliest known breast cancer in the family | Annually |
| If severe breast dystrophy | ||
| Clinical breast exam and breast MRI | Age 20 years or before if symptomatic | Annually |
| Prophylactic mastectomy | Age 25–30 years | |
| Colon | ||
| Colonoscopy | Age 30 years | Every 5 years or every 3 years if polyposis or adenomas found |
| Kidney | ||
| Renal ultrasound and/or renal MRI | Age 30 years | Annually if family history of renal cancer or every 2 years if not |
| Endometrium | ||
| Endometrial ultrasound | Age 35–40 years or 5 years before earliest known endometrial cancer in the family | Annually |
| Hysterectomy | If symptomatic | |
PHTS, PTEN hamartoma tumour syndrome.