How do you counsel your PALB2 mutation positive breast cancer patients with regards to risk reducing surgery?

I counsel patients with PALB2 mutations that their lifetime risk of breast cancer approaches that of a BRCA2 carrier. There is some element of penetrance of the gene in a familial cohort so that the lifetime risk of breast cancer ranges from about 30% to almost 60% (Antoniou et al. NEJM 2014). Despi...