Author Affiliation: Departments of Medical History and Ethics and Medicine, University of Washington, Seattle.
Clinicians frequently make recommendations in the absence of data. They
do so because they have no choice: clinical questions must be addressed even
when appropriate evidence is not available. For some decisions, the uncertainties
about risks and benefits are so problematic that physicians and patients await
study results with great anticipation—sometimes, even with fear. An
example is the question of whether women with a genetic susceptibility to
breast cancer should use oral contraceptives (OCs), weighing a possible increase
in breast cancer risk against the convenience of this means of birth control
and its potential to reduce ovarian cancer risk. The study by Grabrick and
coauthors1 in this issue of THE JOURNAL confirms
that breast cancer risk is a real concern in this setting.
Burke W. Oral Contraceptives and Breast CancerA Note of Caution for High-Risk Women. JAMA. 2000;284(14):1837-1838. doi:10.1001/jama.284.14.1837