Books, Journals, New Media |


Francois Eisinger, MD; Claire Julian-Reynier, MD; Hagay Sobol, MD; Dominique Stoppa-Lyonnet, MD; Christine Lasset, MD; Catherine Nogues, MD
JAMA. 2000;283(2):202-203. doi:10-1001/pubs.JAMA-ISSN-0098-7484-283-2-jbk0112.
Text Size: A A A
Published online


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.

Figures in this Article


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure. Acceptability Reported by Patients and Computed Effectiveness of Prophylactic Mastectomy by Age at Surgery
Graphic Jump Location

The acceptability of prophylactic mastectomy to women potentially at risk was assessed prior to the first cancer genetic consultation. We plotted the rate at which women and physicians said surgery would be acceptable according to age at which the intervention is hypothetically scheduled. Effectiveness (Ef) of the strategy was computed using the following formula: Ef = C (Dfw), where Dfw is the proportion of cancer-prone women still disease free who accept prophylactic mastectomy at a given age based on Breast Cancer Linkage Consortium penetrance data,3 and C is the efficacy of the intervention (90%) as given by Hartmann et al.2



Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.