For BRCA1 and BRCA2 carriers, the question of menopausal hormone therapy is among the most consequential — and most frequently mismanaged — clinical decisions they will face. Fear of exacerbating breast cancer risk often leads to blanket avoidance of MHT, leaving high-risk women to suffer the profound consequences of untreated menopause, particularly those who have undergone risk-reducing salpingo-oophorectomy at a young age. In this session, Dr. Joanne Kotsopoulos — Cancer Research Chair in Hereditary Breast and Ovarian Cancer Prevention and one of the world's foremost researchers in BRCA-associated cancer — presents the current evidence on MHT safety, risk, and benefit in BRCA carriers. She will address the critical distinctions between BRCA1 and BRCA2 carriers, the specific implications of surgical menopause in this population, and how clinicians can apply an individualized, evidence-based framework to guide shared decision-making with their highest-risk patients.

Joanne Kotsopoulos, PhD, is a cancer epidemiologist and one of Canada's leading researchers in hereditary breast and ovarian cancer. She holds the Cancer Research Chair in Hereditary Breast and Ovarian Cancer Prevention and serves as a Scientist with the Familial Breast Cancer Research Unit at the Women's College Research Institute, Women's College Hospital. She is also an Associate Professor at the Dalla Lana School of Public Health and the Department of Pharmacology and Toxicology at the University of Toronto.

Dr. Kotsopoulos received her PhD from the University of Toronto and completed her postdoctoral training at Brigham and Women's Hospital and Harvard Medical School. Her research program focuses on BRCA1/2 mutation carriers, examining the hormonal, reproductive, and lifestyle factors that influence hereditary breast and ovarian cancer risk — with the goal of identifying evidence-based, less-invasive prevention strategies that give women and their clinicians real options. Her molecular studies also investigate the BRCA genes themselves, exploring whether cancer risk can be modulated through changes in gene or protein expression. She additionally leads research into prognostic factors in ovarian cancer, one of the most lethal gynecologic malignancies.