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June 21, 2000

Benefit of Prophylactic Mastectomy for Women With BRCA1 or BRCA2 Mutations

JAMA. 2000;283(23):3070-3071. doi:10.1001/jama.283.23.3068f

To the Editor: Dr Schrag and colleauges1 concluded that surgical interventions, particularly prophylactic contralateral mastectomy, may offer substantial life expectancy gains for women with breast cancer and BRCA1 or BRCA2 mutations. However, the data do not support this conclusion.

Their conclusions were based on modeling that led to a calculation of expected additional years of life. While statistically sophisticated, this approach does not provide accurate prognostic information for most patients. There is a more functional way to look at the potential benefits.

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