BRCA Mutation Carrier Clinic

The BRCA mutation carrier clinic supports individuals who carry a BRCA1 or BRCA2 mutation. BRCA1 carriers have a lifetime breast cancer risk of about 65–70% and an ovarian cancer risk of 39–46%, while BRCA2 carriers have a breast cancer risk of about 45–55% and an ovarian cancer risk of 12–20%.

Who is this clinic for?

• Individuals with a known BRCA mutation

What the clinic offers (all in one place):

• Gynecologic examination, including pelvic ultrasound
• Breast check-ups and imaging (mammography, MRI) according to your specialist
• Blood tests for tumor markers
• Access to a multidisciplinary team: gynecologist, breast oncologist, imaging, fertility specialists

Ovarian Cancer Risk-Reducing Surgery (BRCA Carriers)

There are currently no effective early-detection methods for ovarian cancer. Therefore, for women with BRCA1/2 mutations, risk-reducing removal of the fallopian tubes and ovaries (salpingo-oophorectomy) is recommended.

When is surgery recommended?

• BRCA1: around age 35–40
• BRCA2: around age 40–45
• Usually performed after completing childbearing
• Fertility considerations are important, and timing is individualized

How is the surgery performed?

• Typically done laparoscopically (minimally invasive)
• Allows faster recovery, less pain, and short hospital stay

Benefits

• Reduces ovarian cancer risk by ~80–90%
• Also lowers breast cancer risk, especially if performed before menopause

Risks

• Surgical risks are generally low (<1–2%), including bleeding, infection, or injury to nearby organs
• Leads to early menopause if performed before natural menopause

Should the Uterus Also Be Removed?

Removal of the uterus (hysterectomy) is not routinely recommended and is a personal decision.

Key considerations:

• BRCA1: slight increase in aggressive uterine cancer risk (~0.5% vs. ~0.1% in general population)
• BRCA2: no clear increased risk
• Allows estrogen-only HRT, which is safer for the breast
• May be beneficial for women taking tamoxifen that increases uterine cancer risk
• Adds a small surgical risk (<1–2%) and slightly longer procedure

Recovery and long-term effects:

• Avoid intercourse and heavy lifting for ~8 weeks
• No long-term effect on intimate function
• Does not significantly change risk of pelvic organ prolapse

Other factors:

• Prior surgeries, obesity, and medical conditions
• Decision is made individually during consultation

Can Only the Fallopian Tubes Be Removed?

• Removing only the tubes and delaying ovary removal (staged surgery) is experimental
• Not currently recommended by major international guidelines
• Limited evidence, with some cases of cancer still developing

Hormone Replacement Therapy (HRT)

After ovary removal, women may experience sudden menopause symptoms, such as hot flashes, mood changes, and vaginal dryness, as well as long-term effects on bone, heart, and cognitive health.

Options:

• With uterus removed: estrogen-only therapy
• With uterus intact: combined estrogen + progesterone (preferably lower-risk progesterone types)

Pros:

• Improves quality of life and menopausal symptoms
• Helps protect bone and cardiovascular health
• Considered safe for BRCA carriers until natural menopause (~age 50)

Considerations / Cons:

• Not suitable for all patients (e.g., certain breast cancer histories)
• Requires individual risk–benefit discussion

Family Planning – Preventing BRCA Transmission: Preimplantation Genetic Diagnosis (PGD)

PGD allows BRCA carriers to have children without passing on the mutation. During IVF, embryos are tested, and only unaffected embryos are transferred.

• Eligibility: BRCA carriers planning pregnancy
• Access in Israel: Included in the national health basket since 2026

Clinic Details

• Clinic day: Sunday
• Hours: 08:30–12:30

Appointments: We are here to guide and support you throughout diagnosis, planning and treatment, Please make an appointment via email at:

[email protected] or [email protected]

For >> more information