BRCA phenocopies or ascertainment bias?

The authors found an elevated risk of approximately five-fold, which, if true, has considerable implications for the counselling and clinical management of women testing negative for the mutations found in their family. [...]the study of Smith et al, 1 the excess of cases observed among such non-carriers had been noted only anecdotally by many in both the clinical and research settings. [...]the results of these studies are known, we believe that it would be premature to recommend additional screening or chemoprevention for unaffected women who test negative for the BRCA mutation segregating in their family, other than that recommended for women in their age group in the general population.