BRCA1 in clinical breast cancer

It should be clear from this review that most, if not all, questions raised at the beginning have only partial answers at best. Significant gaps remain and must await greater understanding of the biological effects of BRCA1 and BRCA2 alterations; the natural history of molecularly defined mutation-associated breast cancer; and the effects of currently proposed prevention and treatment strategies. In this regard, pediatric oncology may provide a useful paradigm. Tremendous advances can be made, even in very rare diseases, by population-wide inclusion of at-risk individuals in standardized management protocols and rigorous collection of associated outcome data.