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RAD51D: Options for Managing Risk

Learn about the screening and prevention guidelines for people with a mutation in their RAD51D gene. Stay up to date by signing up for our community newsletter.

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Risk Management for People with Inherited Mutations

Experts at the National Comprehensive Cancer Network (NCCN) created guidelines help people with a make decisions about managing their cancer risk.

We recommend that you speak with a genetics expert who can look at your personal and family history of cancer and can help you decide on a plan for managing your risk.

Risk management for specific cancers based on the 2026 NCCN guidelines are listed below. NCCN also recommends that people with an receive education on the signs and symptoms of these cancers. People with a mutation may also qualify for clinical trials looking for more effective screening or prevention for cancer.

Breast cancer in women

Ovarian and fallopian tube cancer

Other cancers

Participate in Research

Risk Reducing Salpingectomy With Delayed Oophorectomy as an Alternative to Risk- Reducing Salpingo-oophorectomy

Breast cancer risk management

Beginning Age	Recommendation	Additional Information
25	Learn to be aware of changes in your breasts.	Self exams may be most informative at the end of the menstrual cycle.
25 (or earlier based on youngest age of breast cancer in the family)	Breast exam by doctor (also known as a clinical breast exam) every 6-12 months.
40 (or earlier based on youngest age of breast cancer in the family)	Yearly .
40 (or earlier based on youngest age of breast cancer in the family)	Discuss the benefits, risks and costs of yearly breast with and without contrast with your doctor.
No set age	Discuss the benefits, risks and costs of medications to lower the risk for breast cancer with your doctor.	Tamoxifen or other estrogen-blocking drugs may lower breast cancer risk. Medications or vaccines are being studied in clinical trials.
75	Have a discussion with your doctor about whether to continue, stop or change breast screening.
Source: NCCN Guidelines: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, , v. 1, 2026.

Gynecologic cancer risk management

Beginning Age	Recommendation	Additional Information
45 - 50	Risk-reducing removal of ovaries and (). Timing of surgery should take into account plans to have children.	The surgery should be done at a facility that has expertise and follows special precautions for people with inherited mutations. This includes a procedure known as an abdominal wash at the time of surgery. The pathologist should do an extensive exam of the using a procedure called SEE-FIM to look for any abnormal changes in the tissue. If an abnormality known as a "serous tubal intraepithelial carcinoma" or STIC lesion is noted in your , you should be referred to a gynecologic oncologist for follow up care. Discuss your plans for pregnancy and fertility concerns with your doctor, and request a referral to a fertility specialist if indicated. Discuss options for managing the effects of early menopause with your doctor. After , a very small risk remains for a related cancer known as primary peritoneal cancer (PPC). There is no effective screening for PPC after . In people with mutations, risk-reducing surgery has been linked to longer survival compared to people who have not had surgery. Similar research has not been done in people with mutations.
45 - 50	Have a discussion with your doctor about the risks, benefits and costs of removing your uterus (hysterectomy) at the time of .	The following factors may affect your decision about hysterectomy at the time of RRSO: If you have a medical history of fibroids or other issues involving the uterus or cervix you might consider a hysterectomy. If you are considering hormone replacement, the type of hormone recommended depends on whether or not you have your uterus. alone increases the risk for uterine cancer. combined with progesterone protects against uterine cancer, but is linked to a higher risk for breast cancer than alone.
Before age 50	Experts believe that most ovarian cancers begin in the . Researchers are studying whether the removal of the only (), while delaying until closer to the age of natural menopause is a safe option for lowering risk in people who are not ready to remove their ovaries. Guidelines recommend that people interested in this approach speak with their doctor about the benefits and risks, and consider enrolling in a research study.	, followed by delayed requires two separate surgeries. At this time, it is not known if is effective for lowering the ovarian cancer risk in high-risk people. For this reason, if you choose to have risk-reducing first, the guidelines recommend that you undergo surgery to remove your ovaries (known as a completion ) at the recommended age. Discuss your plans for pregnancy and fertility concerns with your doctor, and request a referral to a fertility specialist if indicated.
No set age	Speak with your doctor about the benefits, risks and timing of oral contraceptives or intrauterine devices (IUD) to lower the risk for ovarian and cancers.	Oral contraceptives (birth control pills) have been shown to lower the risk for ovarian cancer in high-risk people. intrauterine devices (IUD) may also lower the risk for ovarian cancer in high-risk people. Research on the effect of oral contraceptives on breast cancer risk has been mixed.
No set age	Become aware of ovarian and primary peritoneal cancer symptoms. Report any symptoms that persist for several weeks and are a change from normal to your doctor. Routine ovarian cancer screening using transvaginal and a blood test has not shown benefit and is not recommended.	Symptoms of ovarian cancer include: pelvic or abdominal pain bloating or distended belly difficulty eating feeling full sooner than normal increased urination or pressure to urinate
Source: NCCN Guidelines: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, , v. 1, 2026.

Other cancer screening and prevention

There has not been enough research to show a benefit from screening and prevention for other cancers in people who have a mutation. For this reason, experts recommend managing these risks based on your family history. Cancer screening and prevention research studies may be available.

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Participate in Prevention Research

Below are some of our featured research studies looking at new ways to screen for, prevent or intercept cancer in people with mutations. To search for additional studies, visit our Search and Enroll Tool.