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Without the accoutrements of fame, American actress Angelina Jolie would be just one of many young women who are using genetic knowledge to manage their breast and ovarian cancer risk. However, with her unavoidable celebrity, Jolie’s explanation of her preventive double mastectomy, and possible later oophorectomy, to reduce the risk associated with a BRCA1 mutation (http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html) has again brought breast and ovarian cancer to public attention.

In its essentials, Jolie’s story is an exercise in the clinical management of genetic information to better one’s future health. In such situations, both doctors and patients need time (an often scarce commodity) to negotiate the complex pathway from knowledge to clinical action, as our understanding of diseases and their associations becomes more intricate, but is still incomplete.

Despite the cultural power of a famous actress’s real-life story in creating positive effects on health behaviour in society, the complexities of clinical interpretation and practice — and how they affect patients’…