We thank the correspondent for mentioning the recent publication about the value of screening reported by Buys; the recently published Health Technology Assessment report 113 from the German Institute of Medical Knowledge and Information (Deutsches Institut für Medizinische Dokumentation und Information, DIMDI) (1) regarding individual health services also refers to this study.
Prophylactic adnexectomy in carriers of the BRCA mutation is recommended only for women older than 40 as the risk of developing ovarian cancer suddenly increases, whereas earlier oophorectomy seems to be associated with a rise in other disorders (2).
In our opinion, nothing conclusive can be said about hormone replacement therapy in carriers of the mutation. Short term therapy does not seem to have any negative effects on the risk of breast cancer (3).
Because of the contradictory conclusions reached by the meta-analyses with regard to the contraceptive pill and risk of breast cancer in women carrying the mutation, the consortium can currently not make any recommendation in favor of taking oral contraception (personal communication).
Footnotes
Conflict of Interest Statement
Professor Schmalfeld has received honoraria for speaking from Essex, GlaxoSmithKline, Fresenius Biotech, Amgen, Lilly Germany, Roche International, and Boehringer. Dr Burges declares that no conflict of interest exists.
References
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