Hereditary breast carcinomas that are attributable to BRCA1 / 2 mutations have their own morphological and immunohistochemical characteristics. BRCA1 -associated carcinomas are poorly differentiated infiltrating ductal carcinomas that frequently show morphological features of typical or atypical medullary carcinoma. BRCA2 -associated breast carcinomas tend to be of higher grade than sporadic age-matched controls. BRCA1 tumors have been found to be more frequently estrogen receptor- and progesterone receptor-negative, and p53-positive than are age-matched controls, whereas these differences are not usually found in BRCA2- associated tumors. In addition, BRCA1- and BRCA2- associated breast carcinomas show a low frequency of HER2 expression. Most BRCA1 breast carcinomas are characterized by the expression of basal (myoepithelial) markers, such as cytokeratin 5/6 and or P-cadherin. These features could be used to distinguish patients who are likely to carry a BRCA1 or BRCA2 germline mutation, thus indicating which gene should be screened for first in families with a high incidence of breast and ovarian cancer.