Two recent consensus statements, one from the USA and one from France, made recommendations about clinical management of women with an inherited predisposition to breast cancer and ovarian cancer due primarily to the presence of BRCA1 or BRCA2 susceptibility-conferring alleles. The groups formulating these statements had the difficult task of making recommendations despite inadequate or equivocal evidence on risk reduction strategies. The two sets of recommendations are similar for the most part, but they diverge in some areas of clinical uncertainty (...) (panel). We believe that the divergence in three areas—breast self-examination, lifestyle, and prophylactic surgery—partly reflects the cultural context in which physicians and patients make decisions and health policies are formulated. (shrink)