Hereditary breast and ovarian cancer (and hormones)

Knowledge of carriership of a predisposition for hereditary breast and ovarian cancer (HBOC) imposes greater demands on gynaecologists, patients and healthy mutation carriers in terms of prevention, therapy and aftercare. Treatment with poly ADP ribose polymerase (PARP) inhibitors is still mainly reserved for tumors with positive breast cancer gene (BRCA) status. The results of healthcare research has enabled a differentiated discussion of the significance of intensified surveillance of the breast compared to risk-reducing surgery in the face of competing risks. Although the clinical care of carriers of a pathogenic variant of BRCA1 or BRCA2 has been introduced in the clinical guidelines, many questions remain unanswered, such as the influence of exogenous hormones and other genetic and non-genetic risk factors on cancer risk. In addition, the characteristics of the newer HBOC genes with moderate risk for breast and/or ovarian cancer and of the rare syndromic genes are not well known as yet. The following article presents HBOC syndrome with current clinical recommendations, including hormonal contraception.