Heterogeneity and natural history of hereditary breast cancer. Surgical implications.

The properly compiled cancer family history can prove to be one of the most cost-effective and powerful instruments for cancer control in breast cancer. Needed, however, is an understanding of the heterogeneity of hereditary breast cancer and knowledge of those facets of its natural history that can expedite a syndrome diagnosis. Priority concerns for cancer control in hereditary breast cancer are the development of registries of cancer-prone families, willingness by third-party carriers to help defray the costs of surveillance, and more research in molecular genetics.