For example, risk-reducing mastectomy and reconstruction in a BRCA1-positive 35-year-old patient leads to much greater risk reduction for breast cancer mortality than that same intervention in a 65-year-old patient.23,37,38 The surgeon should discuss these issues and refer to other specialists (such as gynecologic oncologists, gastroenterologists, etc.)for other organs at risk as appropriate. This evidence concerns the gene BRCA1 and breast carcinoma.