I haven't kept the original post about the woman considering prophylactic
bilateral mastectemy, but I'll put in my $0.02 worth!
Did she have a really strong family history (early onset of breast or
ovarian cancer ie <35, bilateral breast cancer, or 2 or more affected
first-degree relatives with either breast or ovarian cancer)?
There are a large number of possible mutations on the breast cancer genes
(BRCA1 and 2), so usually they test an affected relative first to determine
if they have one of the known mutations. If they find a mutation, then they
can test other relatives who want to know if they are carriers of the
mutation. In Ashkenazi Jewish women, there is a certain mutation which is
common and so they can be tested without needing an affected relative.
This is a very difficult area: to test or not to test? to operate or not? I
have a friend in this position...
A recent article that discusses this is *The Human Genome Project and
Breast Cancer* by Olufunmilayo I. Olopade from the University of Chicago,
in Women's Health Issues 7; 4 (July/August) 1997:209-214.
Lisa Amir
GP / IBCLC in Melbourne, Australia