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SABCS 2025 | Managing cancer risk in BRCA1 mutation carriers without prior breast cancer

Halle Moore, MD, Cleveland Clinic, Cleveland, OH, comments on management options for women with a known BRCA1 mutation without a history of breast cancer, including enhanced surveillance with MRI screening and clinical breast exams, or preventive surgery such as bilateral mastectomy or bilateral salpingo-oophorectomy, which can reduce the risk of both ovarian and breast cancer. Individualized discussions with patients are important, where clinicians should take into account their future fertility plans and personal preferences. This interview took place at the San Antonio Breast Cancer Symposium (SABCS) 2025 Meeting in San Antonio, TX.

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Transcript

Women who have a known BRCA1 mutation without a breast cancer history are usually recommended to undergo either enhanced surveillance such as inclusion of MRI screening in addition to annual mammogram screening and clinical breast exams or to preventive surgery, which can be bilateral mastectomy or removal of both ovaries, bilateral salpingo-oophorectomy, because that, or both, and the removal of the ovaries not only reduces ovarian cancer risk, but also reduces breast cancer risk...

Women who have a known BRCA1 mutation without a breast cancer history are usually recommended to undergo either enhanced surveillance such as inclusion of MRI screening in addition to annual mammogram screening and clinical breast exams or to preventive surgery, which can be bilateral mastectomy or removal of both ovaries, bilateral salpingo-oophorectomy, because that, or both, and the removal of the ovaries not only reduces ovarian cancer risk, but also reduces breast cancer risk. So these are conversations that need to be had with patients on an individual basis. Consideration for future fertility plans needs to be taken into account. And so these are discussions that need to be individualized for each patient. Now for a woman who has a known breast cancer and who has identification of a BRCA mutation, we do have data that consideration of bilateral mastectomy and bilateral salpingo-oophorectomy will improve survival.

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