Hormone replacement therapy is often a concern for women with positive mutations who undergo prophylactic ovariectomy before menopause. Surgery can lead to sudden menopause and a series of other different symptoms. For postoperative women who have side effects of severe menopausal syndrome (such as vasoconstriction and insomnia), short-term hormone replacement therapy is an option to improve the quality of life, especially if the uterus is removed.
For these high-risk groups, there are still different views on whether to use hormone replacement therapy, which focus on from non-hormone replacement therapy to hormone replacement therapy until the occurrence of natural menopause. A large sample shows that data on hormone replacement therapy in BRCAI and BRCA2 carriers have been extrapolated, but hormone use in these populations still needs to be prospectively evaluated. Long-term hormone replacement therapy is not recommended because genetic mutations increase the risk of breast cancer, and further studies are needed in the future to study the side effects of ovariectomy on the brain, bone, and heart d blood tube system.Breast cancer strategies for screening or reducing the risk of breast cancer in women with BRCAI and BRCA2 genes can be divided into three parts, including enhanced cancer screening, chemoprophylaxis, and prophylactic surgery. According to the recommendations of the National Comprehensive Cancer Network, women with mutations in the BRCAI and BRCA2 genes should go to relevant health care institutions for clinical breast examinations every six months from the age of 25 (www.nccn.org). Mammography usually starts at the age of 25, but it can be adjusted according to different cancer patterns in the family. For women with dense breast tissue, auxiliary ultrasound examination should be considered, and research is under way to determine its effectiveness.Recently, magnetic resonance imaging (MRI) has become a routine test for carriers of mutant genes in breast cancer. The American Cancer Society recommends that women with a higher risk of breast cancer (with a lifetime risk greater than 20%) should be tested for mammography and MRI annually. The optimal interval between these checks (for example, one of the two tests completed every six months, alternately) has not yet been determined. A retrospective study of using MRI as a further means of key targeting and ultrasound to screen young women at high risk of the disease found that MRI as a screening strategy had higher sensitivity compared with molybdenum alone or with molybdenum and ultrasound, with or without clinical breast examination. It is unclear whether this higher sensitivity can detect early-stage cancer or reduce patient mortality compared with molybdenum targets alone. Compared with molybdenum targets, MRI-based screening is more sensitive, especially among young women, so the American Cancer Society's recommended screening methods may change with the accumulation of data related to MRI as a screening tool.
