Identification and management of hereditary breast-ovarian cancers (2004 update)

Background. - Since the last recommendations, up to 2500 new references had been published on that topic. Methodology. - On the behalf of the health Minister, the Ad Hoc Committee consisted of 13 experts carried out a first-version revisited by five additional experts who critically analyzed the first version of the report. Main updating. - Breast and ovarian cancer seem to be associated with fewer deleterious mutations of BRCA1 and BRCA2 than previously thought. The screening of ovarian cancer is still not an attractive option while in contrast MRI may be soon for these young women with dense breast, the recommended option for breast cancer screening. The effectiveness of prophylactic surgeries is now well established. French position is to favor such surgeries with regard to a quality of life in line with the expected benefit, and providing precise and standardized process described in the recommendation. Conclusions. - Due to methodological flaws, the low power and a short follow-up of the surveys, this statement cannot however aspire to a high stability. (c) 2006 Publie par Elsevier SAS.