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Mark E. Robson, MD; Kenneth Offit, MD, MPH

JAMA. 2004;292:1368-1370.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Approximately a decade ago, germline mutations in BRCA1 and BRCA2 were identified as the most common detectable causes of a hereditary predisposition to breast (and ovarian) cancer.^1-2 A recent meta-analysis of 22 studies indicated that the average risk of breast cancer by 70 years is 65% for women with BRCA1 mutations and 45% for BRCA2 mutations,³ although the risk may be substantially higher in some families. Women with BRCA1 mutations in their fourth and fifth decade of life have on average approximately a 30-fold higher risk of breast cancer than women without mutations, and BRCA2 mutation carriers are at 10-fold to 16-fold higher risk.³

Confronted by breast cancer risks of this magnitude, it is not surprising that a significant fraction of mutation carriers elect to undergo prophylactic mastectomy, a procedure that has been shown to reduce breast cancer risk by 90% or . . . [Full Text of this Article]

Author Affiliations: Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, NY.

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