BMJ  2008;336:1270 (7 June), doi:10.1136/bmj.39598.672500.DB

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Netherlands debates screening for breast cancer

Tony Sheldon

1 Utrecht

The first 150 words of the full text of this article appear below.

Plans to extend the screening of embryos for genetic mutations linked to hereditary breast cancer have caused a split in the Dutch coalition government. Ethical questions have been raised because for the first time in the Netherlands preimplantation genetic diagnosis will be available for mutations if the chance of developing the disease, the "penetrance," is less than 100%.

Preimplantation genetic diagnosis is used in combination with in vitro fertilisation to select healthy embryos for reimplantation in the womb. Screening is already permitted for genetic conditions such as Huntington’s disease and cystic fibrosis, which have 100% penetrance. The new plan would include breast cancers linked to the genetic mutations BRCA1 and BRCA2 and hereditary intestinal cancers, which have a 40%-90% chance of developing the disease.

The junior health minister Jet Bussemaker accepts that extending screening would mean including cases for which the chance of developing the disease varies according to the . . . [Full text of this article]


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