BACKGROUND: Women who are at increased risk for breast and ovarian cancers, 
especially BRCA1 and BRCA2 mutation carriers, face a myriad of risk-reduction 
options, including increased surveillance, chemoprevention, prophylactic 
oophorectomy, and prophylactic mastectomy. However, little is known about which 
clinical, demographic, or cancer-related factors are associated with 
risk-reduction interventions.
METHODS: The authors conducted a retrospective review of records for 554 women 
who had undergone testing at The University of Texas M. D. Anderson Cancer 
Center between 2000 and 2006 for deleterious BRCA1 and BRCA2 gene mutations. 
Data were collected on the risk-reduction interventions these women adopted 
after they underwent genetic testing. These data were tested for associations 
with demographic and clinical characteristics.
RESULTS: Among the 554 women who underwent genetic testing for BRCA mutation, 78 
were found to have a deleterious mutation in the BRCA1 gene, and 54 had a 
mutation in the BRCA 2 gene. Of the 554 women, 85 underwent prophylactic 
mastectomy, 30 prophylactic oophorectomy, and 52 both surgeries; 387 women opted 
for surveillance. Women who had BRCA mutations, a history of breast cancer or 
ductal carcinoma in situ (DCIS), or previous breast biopsies were more likely to 
have prophylactic surgery. Women with a family history of ovarian cancer were 
more likely to undergo prophylactic oophorectomy. Women with a personal history 
of ovarian cancer or advanced breast cancer were more likely to undergo 
surveillance only. Women with breast cancer who had had a total mastectomy as 
part of their prior breast cancer treatment underwent prophylactic mastectomy 
more frequently than women who either had breast-conserving surgery or no 
history of breast cancer. In multivariate analysis, only positive BRCA mutation 
carrier status was associated with having had prophylactic surgery. In addition, 
breast cancer history was significantly associated with prophylactic mastectomy.
CONCLUSIONS: Women who were BRCA carriers, women who had a history of breast 
cancer, DCIS, or breast biopsy, or had a family history of ovarian cancer were 
more likely to have undergone surgery for cancer risk reduction. Women with 
ovarian cancer or advanced breast cancer were more likely to have undergone 
surveillance.