Nearly every BRCA mutation carrier's main concern is how to avoid the fate of relatives who have had, and possibly died from, breast or ovarian cancer.

Risk reduction for BRCA2 carriers includes taking tamoxifen. Removing ovaries prior to age 40 drops breast cancer risk in half. Ovarian cancer surveillance is unfortunately inadequate at early detection, but birth control pills reduce ovarian cancer incidence up to 60%.

About 80% of women diagnosed with breast cancer do not have a single relative with breast cancer.

By empowering people to initiate a conversation prior to surgery regarding their pain control options, we hope to reduce the incidence of narcotic addiction and all of the unfortunate consequences that surround it.

Options other than mastectomy include high risk surveillance and risk reduction. Surveillance is a combination of monthly self breast exam, annual mammography and whole breast screening ultrasound, annual breast MRI, and biannual clinical breast exam.

Nearly every BRCA mutation carrier's main concern is how to avoid the fate of relatives who have had, and possibly died from, breast or ovarian cancer.

In my practice, the majority of mutation carriers choose mastectomy; however, for those without cancer, they have much more control over the timing. For younger women, we might wait until they have found a life partner, or until after childbearing. Older women who find out they carry a mutation have unwittingly escaped a large percentage of their risk, and therefore, the calculated future risk is not necessarily a daunting number.