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Annals of Surgical Oncology, 13(10): 12961321DOI: 10.1245/s10434-006-9036-6JoseG. Guillem, MD, MPH,1 William C. Wood, MD,2 Jeffrey F. Moley, MD,3 Andrew Berchuck, MD,4 Beth Y. Karlan, MD,5 David G. Mutch, MD,6 Robert F. Gagel, MD,7 Jeffrey Weitzel, MD,8 Monica Morrow, MD,9Barbara L. Weber, MD,10 Francis Giardiello, MD,11 Miguel A. Rodriguez-Bigas, MD,7 James Church, MD,12 Stephen Gruber, MD,13 and Kenneth Oft, MD, MPH141Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Room C-1077, New York, New York 10021, USA2Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA3Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA4Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA5Department of Obstetrics and Gynecology, Cedars Sinai Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, California, USA6Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA7Department of Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA8Department of Clinical Cancer Genetics, City of Hope National Medical Center, Duarte, California, USA9Department of Surgery, Fox-Chase Cancer Center, Philadelphia, Pennsylvania, USA10Departments of Medicine and Genetics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA 11Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA12Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA13Department of Medicine, The University of Michigan Medical Center, Ann Arbor, Michigan, USA14Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USABackground: A signicant portion of cancers are accounted for by a heritable component, which has increasingly been linked to mutations in specic genes. Clinical interventions have been formulated for mutation carriers within affected families. The primary interventions for mutation carriers of highly penetrant syndromes are surgical.Methods: The American Society of Clinical Oncology and the Society of Surgical Oncology formed a task force charged with presenting an educational symposium on surgical management of hereditary cancer syndromes at annual society meetings, and this resulted in a position paper on this topic. The content of both the symposium and the position paper was developed as a consensus statement.Results: This article addresses hereditary breast, colorectal, ovarian/endometrial, and multiple endocrine neoplasias. A brief introduction on the genetics and natural history of each disease is provided, followed by detailed descriptions of modern surgical approaches, clinical and...