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BRCA Risk Management — SCE Medical Oncology MCQ

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ModerateCancer GeneticsBRCA Risk ManagementSCE Medical Oncology

A 32-year-old woman is found to carry a germline BRCA1 mutation after her sister was diagnosed with breast cancer at 35. She has no personal history of cancer. She is considering risk-reducing strategies. At what age should she consider risk-reducing bilateral salpingo-oophorectomy (RRBSO)?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Between 35-40 years for BRCA1 carriers (after completion of childbearing)

NICE CG164 and international guidelines recommend RRBSO for BRCA1 carriers ideally between ages 35-40 (after completion of childbearing), as ovarian cancer risk begins rising significantly from the late 30s. For BRCA2 carriers, RRBSO can be deferred to age 40-45 as ovarian cancer risk rises later. RRBSO reduces ovarian/fallopian tube cancer risk by approximately 80% and also reduces breast cancer risk (by approximately 50%) through oestrogen deprivation, though this comes with menopausal consequences.

Reference: NICE CG164 Familial breast cancer; ESMO 2024 Hereditary Cancer Guidelines