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June 22, 2017. It turns out all BRCA mutations aren’t created equal. A prospective cohort study of female carriers of BRCA1 (n=6036) and BRCA2 (n=3820) mutations published this week in JAMA shows that family history still matters. For BRCA1 and BRCA2 the cumulative risks prior to age 80 for breast cancer was 72% and 69%, respectively, and for ovarian cancer was 44% and 17%. Interestingly, even among known carriers, having at least two first- or second-degree family members with breast cancer posed an additional increased risk. Which gives yet another reason to lament the fact: you can’t choose your family.