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NCCN Hereditary Breast and Ovarian
Cancer Guidelines: 2016 Update
Medical Management: In 2016. NCCN updated medical
management guidelines for several genes and notably, they
included new guidelines for several moderate risk genes
included on the Myriad myRisk Hereditary Cancer panel :
•NCCN still recommends risk-reducing salpingo-oophorectomy
between the ages of 35-40 and upon completion of childbirth for
BRCA1/BRCA2 However, the current version states that it is
reasonable for BRCA2 carriers who have undergone bilateral
mastectomy to delay oophorectomy until 40-45 years, since
the average age of onset of ovarian cancer in BRCA2 mutation
carriers is 8-10 years later than in BRCA1 population.
•Discuss the option of risk-reducing mastectomy for PALB2
mutation carriers.
•Recommend/consider risk-reducing salpingo-oophorectomy
(RRSO) for BRIP1, RAD51C, and mutation carriers.