To the Editor.—We were disturbed to read the discussion on breast cancer risk in the article by Bland et al1 in the February 1986 issue of the Archives. As a geneticist who specializes in breast cancer risk analysis and a surgeon who has held in-depth discussions with women about risk for many years, we are concerned that this article will result in a misunderstanding of risk that in turn may lead to unnecessary prophylactic mastectomies.
Bland et al state that "a woman whose mother has had breast cancer is at increased risk of 80%." They do not appear to realize that some women with an affected mother or sister have no significant increase in risk.2,3 Instead, their statement suggests a blanket high risk that may not be present in many cases.
Bland et al make use of relative risk figures, which in our experience can lead to