To further characterize factors associated with chemotherapy receipt and help advise unaffected BRCA1/2 and PALB2 carriers about the likelihood of requiring chemotherapy if diagnosed with an early-stage breast cancer in the future, we performed a multi-centered retrospective cohort study of affected BRCA1/2 and PALB2 carriers diagnosed between 2002 and 2022. Here, PALB2 is linked to breast carcinoma.