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July 23, 1997

Benefits and Risks of Screening Mammography in Women With BRCA1 and BRCA2 Mutations-Reply

Author Affiliations

University of Washington Seattle
Fox Chase Cancer Center Philadelphia, Pa
Dana-Farber Cancer Institute Boston, Mass
University of Utah Salt Lake City Mary Jo Ellis Kahn National Breast Cancer Coalition Richmond, Va
University of Texas Houston
Fred Hutchinson Cancer Research Center Seattle, Wash
Memorial Sloan-Kettering Institute for Cancer Research New York, NY
Claudette Varricchio, DSN, RN National Cancer Institute Bethesda, Md
The Johns Hopkins University Baltimore, Md
National Human Genome Research Institute Bethesda, Md

JAMA. 1997;278(4):290. doi:10.1001/jama.1997.03550040046031

In Reply.  —We agree with Ms Gilson and Drs Vaidya andBaum that there is a potential risk from mammography for women carrying BRCA1 and BRCA2 mutations, but we believe there is a greater likelihood of benefit. Vaidya and Baum note recent publications indicating a DNA repair function for the BRCA1 and BRCA2 protein1-3 and suggest that these observations raise questions about the use of screening mammography for individuals carrying mutations in these genes. While a defect in a DNA repair mechanism may increase the risk of radiation exposure, we believe it would be premature to conclude that individuals carrying BRCA1 or BRCA2 mutations will be "exquisitely sensitive to even small amounts of ionizing radiation." This research finding is preliminary and of uncertain clinical significance. It may mean that cancers associated with BRCA1 and BRCA2 mutations are more sensitive to radiation. Further, while mammography may pose risk, it also remains the

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