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Simple Summary: This study summarizes the current landscape of breast cancer risk reduction strategies in East and Southeast Asia, especially in the context of the rising interest in risk-based screening. Clinical trial results and European guidelines may not always be directly applicable to Asian populations due to differences in healthcare systems, disease prevalence, lifestyle factors, and genetic predispositions. By focusing on regional evidence, we can potentially identify gaps and areas where Asian populations may benefit from new or modified approaches. Asian evidence can inform more relevant and effective local practices. Breast cancer (BC) screening enables early detection and timely treatment of cancer. Improving the effectiveness of BC screening can be accomplished by personalizing screening schedules according to each woman's specific risk level. However, when informing women about their risk classification, especially those at high risk, it is important to give clear recommendations on how to lower their risk. BC risk reduction comprises lifestyle modifications, preventive surgery, and chemoprevention, with the latter two being particularly applicable to high-risk individuals. Public health guidance on risk-reducing interventions is heterogeneous and context-dependent. We conducted a scoping review on BC surgical interventions and chemoprevention in East and Southeast Asia in publications between 2010 and 2024. We searched two databases and identified 23 publications relevant for inclusion. The highest number of publications came from South Korea (n = 9). More publications discussed surgical interventions compared to pharmacological interventions. The studies were largely observational and utilized data from medical records. Most studies defined high-risk individuals as BRCA carriers, many of whom previously had cancer. The field would benefit from randomized studies of BC prevention strategies focusing on Asian populations. Future research could explore women's sentiments towards chemoprevention compared to prophylactic surgery and could extend the definition of high-risk individuals beyond BRCA carriers. [ABSTRACT FROM AUTHOR]