However, these recommendations were established for women considered high risk for breast or ovarian cancer based only on personal or family history .To date, the benefits of screening and prevention have not been proven in women who carry a mutation in BRCA1 or BRCA2. Clinical screening trials to evaluate this particular population are underway. A CBE three or four times per year is occasionally recommended for women at exceptionally high risk. Third, annual mammography may begin at age 25 to 35 as well. Unfortunately, due to increased breast density in younger women, the sensitivity of mammography is lower in this age group.
Bilateral ultrasound can be a useful adjunct to mammography.
Fourth, chemopreventive agents, such as Tamoxifen, may be an option for some women. Tamoxifen was shown to reduce a woman's risk of breast cancer by half, but the effectiveness in women who carry a mutation in BRCA1 or BRCA2 is unknown. Although this does not guarantee that they will not get breast cancer, the risk is substantially lowered. The ability to reduce ovarian cancer with screening or prevention measures is not proven. Experts recommend that women who carry the BRCA1 or BRCA2 mutation have an annual or semi-annual transvaginal ultrasound to examine the ovaries.