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Risk Management
Read about different genes that are linked to hereditary cancer, their associated risks and guidelines for screening, preventing and treating cancers in people with inherited mutations in these genes.

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Risk Management for People with Inherited Mutations

The National Comprehensive Cancer Network (NCCN) provides risk management guidelines for people with mutations. NCCN guidelines for specific cancers are listed below. 

People with a  mutation may also qualify for clinical trials looking for more effective screening or prevention for cancer.

Breast cancer risk management in women

Beginning age Recommendation Additional information
25 Learn to be aware of changes in your breasts.  
25 Breast exam by doctor every 6-12 months.  
30 Yearly breast with and without contrast.   
30 Yearly .  
No set age Discuss the benefits, risks and costs of double mastectomy with your doctor.

Risk-reducing mastectomy lowers breast cancer risk by 90%, but has not been shown to improve survival. Even after double mastectomy, some breast tissue, and therefore cancer risk remains. 

No set age Discuss the benefits, risks and costs of medications to lower the risk for breast cancer with your doctor.   Tamoxifen or other estrogen-blocking drugs may lower breast cancer risk. Medications or vaccines are being studied in clinical trials.


Risk management for male breast cancer

Beginning age Recommendation
35 Learn how to do a breast self-exam and be aware of changes in your breast.
35 Breast exam by doctor every 6-12 months.
50 (or earlier based on the youngest case of male breast cancer in the family) Have a discussion with your doctor about the benefits, risks and costs of annual mammograms.


Ovarian and cancer risk management


Beginning age Recommendation Additional information

Have a discussion with your doctor about the risks, benefits and costs of risk-reducing removal of ovaries and (). Timing of surgery should take into account plans to have children. 

45-50 Have a discussion with your doctor about the risks, benefits and costs of removing your uterus (hysterectomy) at the time of .

The following factors may affect your decision about hysterectomy at the time of RRSO:   

  • If you have a medical history of fibroids or other issues involving the uterus or cervix you might consider a hysterectomy.
  • If you are considering hormone replacement, the type of hormone recommended depends on whether or not you have your uterus. 
    • alone increases the risk for uterine cancer. 
    • combined with progesterone protects against uterine cancer, but is linked to a higher risk for breast cancer than alone.  
Before age 50

Researchers are studying whether the removal of the  only (), while delaying until closer to the age of natural menopause is a safe option for lowering risk in people who are not ready to remove their ovaries. If you are interested in this approach, talk with your doctor about the benefits and risks, and consider enrolling in a research study.

  • At this time, it is not known if lowers the risk for ovarian cancer in high-risk people. 
  • , followed by delayed  requires two separate surgeries.
No set age Oral contraceptives (birth control pills) have been shown to lower the risk for ovarian cancer. Have a discussion with your doctor about the benefits and risks of oral contraceptives for lowering ovarian cancer risk. 

Research on the affect of oral contraceptives on breast cancer risk has been mixed.

No set age

Become aware of ovarian and primary peritoneal cancer symptoms. Report to any symptoms that persist for several weeks and are a change from normal to your doctor. 

Routine ovarian cancer screening using transvaginal and a blood test has not shown benefit and is not recommended.

Symptoms of ovarian cancer include:

  • pelvic or abdominal pain
  • bloating or distended belly
  • difficulty eating
  • feeling full sooner than normal
  • increased urination or pressure to urinate 


Guidelines for pancreatic cancer risk management

There are two tests that are used to look for pancreatic cancer in high-risk people. 

  • MRCP (Contrast-enhanced magnetic resonance cholangiopancreatography) is a special type of  imaging that looks closely at the pancreas, liver, gallbladder, bile duct and pancreatic duct to find abnormalities such as cancer.
  • EUS (Endoscopic ) involves passing a tiny scope with an attached  probe down the esophagus to the stomach. This allows doctors to look closely at the pancreas.  
Beginning age Family history Recommendation
50 (or earlier based on the youngest case of  pancreatic cancer in the family) For  mutation carriers with a first- or second- degree relative with pancreatic cancer
  • Discuss the benefits, risks, costs and limitations of screening with your doctor.
  • Screening should include annual MRCP or EUS or both. 
  • Screening should be performed in a facility with experience in screening high-risk patients for pancreatic cancer. 



Beginning age Recommendation
  • Have a conversation with your doctor about the potential benefits, risks, costs and limitations of screening for cancer. 
  • If you choose to have screening, the guidelines recommend an annual digital rectal exam and Specific Antigen () test. 


Other cancers

There has not been enough research to show a benefit from screening and prevention for other cancers in people who have a  mutation. For this reason, experts recommend managing these risks based on family history of cancer. Cancer screening and prevention research studies may be available for people with  mutations. 

Get Support
Get Support

FORCE offers many peer support programs for people with inherited mutations. 

Paying For Care
Paying For Care

Health plan coverage of screening and prevention varies, and deductibles, coinsurance and copays often apply. If you need preventive services and your insurance company denies your claim, your health care provider can help you write an appeal letter, or you can use one of our sample appeal letters. If you need information about finding an insurance plan, watch our video: Choosing Wisely: How to Pick Insurance Plans.

Visit our section on Insurance and Paying for Care: Screening and Prevention for more information. 

Open Clinical Trials
Open Clinical Trials

The following are risk-management studies enrolling people with inherited mutations. Check study listings or contact the study team to see if you are eligible. 

Multiple cancers


  • NCT03805919: Men at High Genetic Risk for  Cancer. This is a  cancer screening study using  in high risk men. This study is open to men with , , , , , , , , ,  and other inherited mutations.
  • NCT05129605: Cancer Genetic Risk Evaluation and Screening Study (PROGRESS).  This study will look at how well  MRI works as a screening tool for men at high risk for cancer. This study is open to men with inherited mutations in , , , , , , , , , , , , , , , and other genes. 

Ovarian cancer

Pancreatic cancer

Additional risk-management clinical trials for people with inherited mutations may be found here.

Last updated January 01, 2024