1532 Background: Women who test positive for a germline BRCA1/2 mutation are offered cancer surveillance or risk reducing surgery. Coordinating risk reducing gynecologic surgery with breast and reconstructive surgery is a strategy to consider. Methods: Review of the Cancer Risk Program registry identified 43 BRCA1/2 mutation carriers undergoing concurrent or sequential surgery for RRSO and bilateral mastectomy by the Gynecologic Oncology, Breast Oncology, and Plastic Surgery services. This study evaluates the surgical outcomes of combining risk reducing gynecologic surgery with breast and reconstructive surgery. Student's t-test and chi-square comparisons were used. Results: Between August 1998 to July 2007, 21 women underwent a concurrent procedure of RRSO and bilateral mastectomy, while 14 had RRSO preceded by mastectomy, and 8 had oophorectomy followed by mastectomy. The mean age of all women was 44.9 (range 33–75). In comparison to those undergoing a concurrent procedure, women who had a subsequent separate risk reducing gynecologic procedure had shorter operative time (139 vs. 453 minutes, p< 0.0001) and median hospital stay (1.5 vs. 5 days, p=0.0002). Seventeen of 21 (81%) women having concurrent surgery had a current or prior diagnosis of breast disease. Nine of 21 (43%) women undergoing concurrent RRSO and mastectomy underwent transverse rectus abdominus myocutaneous flap reconstruction, while 2 had deep inferior epigastric perforator flaps, 1 had latissimus dorsi flaps, 5 had implants, and 4 chose no reconstruction. Complications included 2 patients each with fever and transfusion, one patient with ileus, and one with reoperation for flap perfusion. All patients with complications after concurrent surgery had undergone flap reconstruction, and both transfused patients had received breast cancer chemotherapy. Four of 21 women had hysterectomy in combination with the other concurrent surgeries; the median hospital stay for these women was 6 days, and included one of the transfused patients. Conclusions: A multidisciplinary approach to risk reducing surgery offers coordinated care for BRCA1/2 mutation carriers. Particularly in women undergoing breast cancer surgery and flap reconstruction, adding RRSO seems reasonable. No significant financial relationships to disclose.