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Everyone has two copies of each of these genes—one copy inherited from each parent. People who inherit harmful variants in one of these genes have increased risks of several cancers—most notably breast and ovarian cancer, but also several additional types of cancer. The risk for any one woman depends on a number of factors, some of which have not been fully characterized. In women, these include fallopian tube cancer 5, 6 and primary peritoneal cancer 7, both of which start in the same cells as the most common type of ovarian cancer. In addition, certain variants in BRCA1 and BRCA2 can cause subtypes of Fanconi anemia, a rare syndrome that is associated with childhood solid tumors and development of acute myeloid leukemia 15 — The mutations that cause these Fanconi anemia subtypes have a milder effect on protein function than the mutations that cause breast and ovarian cancer.

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Tamoxifen is indicated for the treatment of breast cancer in a variety of settings. It should be noted that evidence suggests that patients with estrogen receptor-positive tumors are more likely to benefit from tamoxifen. FDA-approved Indications include treatment of breast cancer in both females and males, adjuvant treatment of breast cancer after patients have completed their primary treatment with surgery and radiation, treatment of female patients with ductal carcinoma in situ non-invasive breast cancer after surgery, and radiation to reduce the risk of invasive breast cancer, and breast cancer risk reduction in certain patients at high risk. Tamoxifen also has many off-labeled uses, and they may require additional data. This activity outlines the indications, mechanism of action, methods of administration, important adverse effects, contraindications, toxicity, and monitoring, of tamoxifen, so providers can direct patient therapy in treating indicated disorders as part of the interprofessional team.

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