Risk of ovarian cancer is increased by A history of ovarian cancer in a 1st-degree relative Nulliparity Delayed childbearing Early menarche Delayed menopause A personal or family history of endometrial, breast, or colon cancer Risk is decreased by Oral contraceptive use Germline alterations in breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) genes are identified in 14 to 18% of patients with high-grade serous ovarian cancer; 3% have somatic BRCA mutations (BRCAm) or inactivation due to methylation (1).