Management of the contralateral breast in patients with hereditary breast cancer

Approximately 5% of all breast cancers arise on a background of one of the high-risk breast cancer genes (hereditary breast cancer and hereditary breast and ovarian cancer). An estimated 20% of cases arise in the presence of a less striking family history with later average age at onset and lower penetrance, familial breast cancer. For hereditary breast cancer, bilaterality is a recognized feature. Cancers often present at an early age with the contralateral risk high. This article explores the current state of knowledge regarding management options for women with hereditary breast cancer.