Medical Options for People with BRCA1 and BRCA2 Mutations
Several medical options are available for managing breast, ovarian, prostate, and pancreatic cancer risk in people who have BRCA1 or BRCA2 mutations, but who have not yet had these cancers themselves. These options have risks and benefits, and you should discuss them with a doctor knowledgeable about medical management for people with BRCA1 or BRCA2 mutations.
Breast and ovarian cancer risk management
Women with BRCA1 and BRCA2 mutations are more likely to get breast and ovarian cancer than other women.
The most effective option for preventing breast and ovarian cancer in women with BRCA mutations is surgery to remove the breasts (mastectomy) and ovaries and fallopian tubes (salpingo-oophorectomy).
Other available options may reduce the chance of developing cancer or improve the likelihood of detecting it earlier, but the effectiveness of these options is less certain.
- Taking medications (such as tamoxifen and raloxifene, and aromatase inhibitors) to lower the chance of developing breast or ovarian cancer
- Yearly screening with breast magnetic resonance imaging (MRI) and mammogram, starting at a younger age
- Clinical breast exams, starting at a younger age and done more frequently
- Screening for ovarian cancer with transvaginal ultrasound and CA-125 blood tests
- Engaging in healthy behaviors, such as keeping a healthy weight and exercising regularly
- Paying attention to how your breasts normally look and feel and letting your doctor know right away if you notice any changes
BRCA genetic testing can also guide treatment options for women with breast or ovarian cancer to prevent future cancers. For example, women with cancer in one breast who test positive for a BRCA1 or BRCA2 mutation may opt to have both breasts removed, rather than having surgery only on the affected breast.
Men with BRCA1 and BRCA2 mutations are more likely to get breast cancer than other men. If you are a man with a BRCA1 or BRCA2 mutation, your doctor may recommend the following:
- Breast self-exam training and education starting at age 35
- Yearly clinical breast exams starting at age 35
- Consider yearly mammographs starting at age 50, or 10 years younger than the earliest known male breast cancer in the family, whichever is younger
Prostate cancer risk management
Men with BRCA1 and BRCA2 mutations are more likely to get high-grade prostate cancer than other men. If you are a man with a BRCA1 or BRCA2 mutation, your doctor may recommend prostate cancer screening starting at age 40, especially for men with a BRCA2 mutation.
Pancreatic cancer risk management
Both men and women with BRCA mutations are more likely to get pancreatic cancer. If you have a BRCA mutation and a close relative with pancreatic cancer, then your doctor may recommend that you consider screening for pancreatic cancer starting at age 50, or 10 years younger that the earliest known pancreatic cancer in your family, whichever is younger.