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February 19, 1997

Genetic Polymorphisms and Breast Cancer Risk

Author Affiliations

The Association of Maryland Hospitals and Health Systems Lutherville

JAMA. 1997;277(7):533. doi:10.1001/jama.1997.03540310031027

To the Editor.  —Western medicine is at a crossroads regarding the understanding of health and disease. Indeed, the discovery of genetic predisposition to diseases previously believed to be primarily "caused" by exposure is changing our appreciation of multifactorialism. Increasingly, biomedical scientists are compelled to learn more about the patient to understand the disease and to appreciate the patient's culture in order to prescribe the acceptable path toward healing the ailment. In short, the discovery of oncogenes may have transformed Western medicine from a disease management doctrine to a social science, perhaps revisiting the nature vs nurture conundrum. And in that transformation medicine may have rediscovered a concept common to many cultures— the concept of destiny.That a person's N-acetyltransferase 2 (NAT2) profile increases susceptibility to breast cancer is a proposition similar to those derived from other potential correlations discovered in the past few years between genetics and incidence of