How do you counsel premenopausal women with BRCA1 or BRCA2 mutations on the need for bilateral oopherectomy?

I typically mirror the NCCN guidelines in this area. For those with BRCA 1 mutations, I recommend RRBSO between age 35-40 after completion of childbearing. Because those with BRCA2 mutations typically have onset of ovarian cancer later, it is reasonable to delay until age 40-45.

Counseling needs to ...

It is reasonable to consider BSO late 30's for BRCA1 and early 40's for BRCA2 germline mutations.