Localizing the Global : Testing for Hereditary Risks of Breast Cancer

Tests for hereditary predispositions to breast and ovarian cancer have figured among the first medical applications of the new knowledge gleaned from the Human Genome Project. These applications have set off heated debates on general issues such as intellectual property rights. The genetic diagnosis of breast cancer risks, and the management of women "at risk" has nevertheless developed following highly localized paths. There are major differences in the organization of testing, uses of genetic tests, and the follow up of patients. This article studies testing practices and ways of managing breast cancer risk in France and compares them with those in the United States and United Kingdom. It shows how the complex interaction between global and local factors shapes the multiple meanings assumed by the phrase cancer risk.