Would you consider HRT after BSO in a pre-menopausal gBRCA2+ patient who has no intention of ever having prophylactic bilateral mastectomies and who declines chemoprophylaxis?  

Yes, I would consider HRT in this patient with several caveats and realizing that there are no data specifically applicable to this situation. Still, one can make inferences from the existing literature.  There are well-documented long-term effects and lower survivals in younger women who have ...

I agree with @Debu Tripathy and @Adam Brufsky. There are a lot of options to manage menopausal symptoms in this scenario. One option to discuss with her, especially if she retained her uterus, is estrogen/bazedoxefine (Duavee). There is interesting early data that this combo relieves menopausal symp...