We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
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

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

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



Also 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.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
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.


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

22 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

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