Acceptable Strategies for Dealing With Hereditary Breast/Ovarian Cancer Risk

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Abstract
Since the breast cancer genes BRCA1 and BRCA2 were identified, it has become possible to determine the gene carrier status in women. However, no conclusive data are available so far about the efficacy (1) of the three main strategies for managing hereditary breast and ovarian cancer, i.e., prophylactic surgery, screening, and chemoprevention with tamoxifen (2). In situations involving major uncertainty, the a priori acceptability of the available strategies is one of the main criteria used in setting up preventive programs. Although Lerman et al. (3) have reported that, among 12 unaffected women with a BRCA1 germline mutation, the declared acceptability rate of prophylactic mastectomy and oophorectomy was 17% and 33%, respectively, no comparative studies have been carried out so far on the acceptability of the various strategies.

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