Owing to the significant breast cancer risk associated with BRCA1 or BRCA2 mutations, women with these mutations have several options available to them by which to reduce the risk of breast cancer. These include surgical (prophylactic mastectomy and prophylactic oophorectomy) and medical (chemoprevention) options. The breast cancer risk reductions associated with these options range from a 90% risk reduction associated with prophylactic mastectomy to approximately 50% with oophorectomy or tamoxifen. This article reviews the efficacy of prophylactic oophorectomy for the prevention of breast cancer in BRCA1 and BRCA2 mutation carriers. The predictors of uptake of the preventive surgery will be discussed, in addition to the psychosocial implications of the surgery.