Cancer risk assessment, risk factors and risk management options may differ for people with hereditary cancer risk or a BRCA mutation than for people in the general population. It is important to consult an expert in cancer risk assessment and risk management to determine what your personal risk for hereditary cancer may be. For more information, see our finding a specialist in hereditary cancer section.

Risk factors
Cancer is a disease with many contributing factors. The following factors may impact the risk for cancer; some may have a different impact for BRCA mutation carriers or people with hereditary cancer risk than people with average cancer risk. Currently it is unknown precisely how risk factors alone or in combination impact someone with a BRCA mutation or hereditary cancer risk.

* Age at menarche (first menstruation)
o In the general population, early menarche has been shown to increase the risk for breast cancer. One study showed similar effect in women with BRCA 1 mutations. Earlier age of first menstruation was associated with an increased risk of breast cancer. This association was not observed among BRCA2 mutation carriers. Compared with BRCA1 carriers who began menstruation at 11 years, women who began menstruation between ages 14 and 15 had a 54% reduction in risk.
* Parity (number of births)
o In the general population, having children before age 30 has been shown to lower the risk for breast cancer. The exact impact of pregnancy and child-bearing on breast cancer risk in BRCA mutation carriers is not totally clear and may be different for BRCA 1 mutation carriers than for BRCA 2 mutation carriers. In one study women with a BRCA 1 mutation who had four or more children had a breast cancer risk that was 38% lower than BRCA 1 mutation carriers who never had children. The same study associated increasing number of births with a significant increase in breast cancer risk in BRCA2 mutation carriers before age 50. The increase was greatest in the 2-year period following a pregnancy.
* Breast-feeding
o One study examined breast cancer incidence in BRCA 1 and BRCA 2 carriers who breast-fed compared with women who never breast-fed. The study found that breast-feeding lowered the risk for breast cancer in BRCA 1mutation carriers who breast-fed for more than one year, but did not find a similar risk reduction in BRCA 2 carriers.
* Medications
o Certain medications such as Tamoxifen may lower the risk for breast cancer in BRCA mutation carriers. Other medications such as oral contraceptives have been shown to lower the risk for ovarian cancer but certain formulations may increase the risk for breast cancer in BRCA carriers. For more information on the effects of medication on cancer risk, visit our section on breast cancer chemoprevention and ovarian cancer chemoprevention.
* Prior surgery
o Prophylactic salpingo-oophorectomy (surgical removal of the ovaries and tubes) in high-risk women has been shown to dramatically lower the risk for ovarian cancer. If the procedure is done prior to menopause, it has also been shown to lower the risk for breast cancer substantially. For more information, see our prophylactic salpingo-oophorectomy section. In addition, a small retrospective study found that tubal ligation substantially lowered the risk for ovarian cancer in women with BRCA 1 mutations but not in women with BRCA 2 mutations.
* Diet
o Although it is believed that certain foods or chemicals in certain foods such as vegetables, fat, dairy and soy may affect breast and/or ovarian cancer risk, the exact effect of diet and its impact on those at risk for hereditary cancer is unknown.
* Exercise
o Exercise offers many health benefits for both BRCA mutation carriers as well as the general population. A study of Jewish women with BRCA mutations showed those active in sports, dance, or casual exercise during their teenage years had a delayed the onset of breast cancer later in life.
* Weight
o A recent study of 1,073 women from five countries suggests losing as few as 10 pounds between ages 18 and 30 may dramatically reduce the risk for breast cancer in those who have a BRCA1 mutation.
* Alcohol consumption
o Regular alcohol consumption has been linked to increased risk for breast cancer risk for women in the general population. The specific effect of alcohol consumption on breast cancer risk in BRCA mutation carriers is unknown.