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Hereditary Cancer Info > Risk Management > Risk Management Guidelines

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Risk Management Guidelines

Learn about the steps that people at high risk for cancer can take to manage their risk and protect their health.

NCCN Guidelines for risk management for men with BRCA mutations

Breast cancer

  • Breast self-exam training and education beginning at age 35
  • Annual clinical breast exam beginning at age 35

 Prostate cancer

  • Prostate cancer screening is recommended for men with BRCA2 mutation, and should be considered for men with BRCA1 mutations beginning at age 40. 

Pancreatic cancer

Pancreatic cancer screening is done using two types of medical procedures: 

  • Magnetic resonance cholangiopancreatography (MRCP) is a special type of imaging MRI that is used to look at the pancreas, liver, gallbladder, bile duct and pancreatic duct. 
  • Endoscopic ultrasound (EUS) involves passing a tiny scope with an attached ultrasound probe down the esophagus to the stomach. This allows doctors to look closely at the pancreas.

Experts guidelines say:

  • People with a mutation in BRCA1 or BRCA2 and those with a family history of pancreatic cancer, are encouraged to discuss the pros and cons of annual screening with their health care provider. 
  • Experts do not currently recommend pancreatic cancer screening for people with a BRCA1 or BRCA2 mutation who do not have a close family history of pancreatic cancer.
  • For those who decide to undergo pancreatic cancer screening, consider beginning at age 50 or 10 years earlier than the earliest pancreatic cancer diagnosis in the family.
  • Screening should begin with annual MRCP and/or EUS (both ideally performed at a center with expertise).

People with a BRCA1 or BRCA2 mutation may also be eligible for pancreatic cancer screening clinical trials. Visit our research study page for links to clinical trials for early detection of pancreatic cancer.

Melanoma screening

  • Education regarding signs and symptoms of melanoma, especially those associated with BRCA gene pathogenic/likely pathogenic variants.
  • General melanoma risk management is appropriate, such as annual full-body skin examination and minimizing sun exposure.

Reproductive options

  • For patients of reproductive age, advise about options for prenatal diagnosis and assisted reproduction including pre-implantation genetic diagnosis. 

Risk to relatives

  • Advise about possible inherited cancer risk to relatives, options for risk assessment, and management.
  • Recommend genetic counseling and consideration of genetic testing for at-risk relatives. 


Updated 02/03/2020

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