Oral contraceptives, salpingo-oophorectomy and hormone replacement therapy in BRCA1-2 mutation carriers.

Germline mutations in BRCA1 or BRCA2 genes redispose to hereditary breast and ovarian cancers. he estimated lifetime risk of breast cancer in BRCA1 utation carriers ranges from 50% to 80%, while the stimated lifetime risk of ovarian cancer ranges from 0% to 65%. Although breast cancer risk is similar in omen who inherit BRCA2 mutations, the lifetime risk f ovarian cancer is approximately 20% [1–3]. In the general population reproductive factors (such s parity, age at menopause, use of exogenous steroid ormones as contraceptives or after menopause) influnce the risk of breast and ovarian cancer. In BRCA utation carriers, these issues are much more compliated and not completely understood. Nonetheless, a rowing number of data show that estrogens may modlate the risk of breast cancer in women with BRCA utations. In these women estrogens may increase the robability of mutation due to enhanced proliferation nd direct genotoxic effects of estrogen metabolites [4]. Women carrying BRCA1 and BRCA2 mutations ace difficult decisions during the reproductive life. n the younger age period, they may be reluctant to sing oral contraceptives (OCs) for the possible influnce of these compounds on breast cancer incidence. fter completion of childbearing, they may be offered he option of prophylactic oophorectomy, that is assoiated with a strong reduction of cancer risk, but also w o T s