As part of an ongoing series of answers to common questions received by the Basser Center for BRCA, Executive Director Susan Domchek, MD, discusses typical guidelines for follow up to a potential recurrence of BRCA-related breast cancer.

Dr. Domchek: Another question that we get a lot is whether or not the follow up of an individual who's had a breast cancer associated with a BRCA1/2 mutation should be different from the follow up of, if you will, a "regular" breast cancer patient. And for that, we want to differentiate the risk of developing a new cancer versus the risk of a recurrence of a cancer that you've already had. So anyone who's had a breast cancer does face some risk of that breast cancer coming back outside the breast, for instance in the bones or the liver or the lungs. We call that metastatic breast cancer.

And whether you have a BRCA1/2 mutation or not, if you've had a breast cancer, there is risk of that occurring. Per guidelines from the American Society of Clinical Oncology and others, we do not do any kind of routine scans in terms of PET-CTs or things like that to look for that recurrence. Instead, we make sure to take to patients about any symptoms that they're having and very promptly evaluate any of those symptoms to check for recurrence. On the other hand, BRCA1/2 mutation carriers are at risk for new cancers: new cancers in the same breast, new cancers in the opposite breast, a risk of ovarian cancer, and particularly for BRCA2, a potential risk for pancreatic cancer. And so we have different strategies in those individuals to look more intensely for those cancers and also if an individual is known to have a BRCA1/2 mutation, and they've had breast cancer, to still plan on a risk-reducing oophorectomy, or removal of the ovaries, at the appropriate time.