Detailed definition
BRCA1 and BRCA2 are tumor suppressor genes involved in DNA double-strand break repair through homologous recombination. Pathogenic variants confer substantially elevated lifetime risks: BRCA1 carriers have approximately 60–70% lifetime breast cancer risk and 40% ovarian cancer risk; BRCA2 carriers have 45–60% breast cancer risk and 15–20% ovarian cancer risk. Standard risk-reduction options include enhanced screening (annual MRI plus mammogram for breast), risk-reducing mastectomy, and risk-reducing bilateral salpingo-oophorectomy (BSO), typically recommended around age 35–40 (BRCA1) or 40–45 (BRCA2) after childbearing is complete. BSO produces immediate surgical menopause. The question of HRT after risk-reducing BSO has been studied: most evidence suggests that HRT until the average age of natural menopause does not negate the breast cancer risk reduction from BSO and substantially mitigates the surgical menopause symptoms and long-term cardiovascular and bone risks. NCCN, NAMS, and other societies generally support HRT in BRCA carriers without prior breast cancer who undergo risk-reducing BSO before natural menopause age.
Why it matters in menopause
BRCA carriers facing risk-reducing BSO often hesitate to take HRT after surgery because of breast cancer concerns. The evidence supports HRT until natural menopause age in this population; the breast cancer risk reduction from BSO is preserved. ClearedRx coordinates with cancer genetics and surgical teams when treating BRCA carriers.
Related terms
Sources
External references: Wikipedia.