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January 12, 2000


Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(2):202-203. doi:10-1001/pubs.JAMA-ISSN-0098-7484-283-2-jbk0112

To the Editor: About 7% of breast cancers are associated with a mutation of BRCA1 or BRCA2.1 Preventive management in the population of women with genetically determined breast cancer is challenging because there are limited data about strategies, efficacy, and risk-benefit ratios. Women who test positive for a BRCA1 or BRCA2 mutation face difficult decisions about whether to undergo prophylactic mastectomy. A substantial benefit of prophylactic mastectomy was recently documented in women with a family history of breast cancer.2 However, from a public health point of view, the impact of any treatment depends not only on efficacy but also on availability, affordability, and acceptability of the procedure. On the assumption that availability and affordability could be achieved, we investigated the acceptability of the procedure.