BRCA1 and obesity due to melanocortin 4 receptor deficiency: At this time, hysterectomy at the time of RRBSO is not recommended in the Canadian and American guidelines for all carriers of BRCA1/2; however, individual risk factors for endometrial cancer, such as familial penetrance, Tamoxifen use, and obesity should be considered, as well as concomitant indications for hysterectomy, including, but not limited to, symptomatic fibroids and prolapse [54,56,71].