Improving Surveillance and Quality of Life of BRCAMutation Carriers TO THE EDITOR: Testing forBRCA1 andBRCA2 germlinemuta-

tions is traditionally performed as part of genetic counseling for families with breast and ovarian cancer with the intention of identi-fying high-risk individuals for disease preventionmeasures. Recently, BRCA status has also emerged as a putative predictive factor for selec-tion of optimal treatment in a group of cancers with adverse tumor biologic features.1-3 If proven to be effective in the adjuvant setting, such treatments may influence the strategies by which healthy muta-tion carriers are counseled and treated, increasing the options for high-risk individuals and leading to important implications for qual-ity of life. The identification ofBRCA1 andBRCA2 in themid-1990s had a vast effect on themanagement of families with breast/ovarian cancer, andmutation analysis soon became a sine qua non in risk assessment and counseling. However, the difficulty to predict an individual’s cancer risk has remained an issue. Early estimates of amore than 80