title: Risk-reduction surgery decisions in high-risk women seen for genetic counseling.
abstract: Women at greatest risk for hereditary breast and ovarian cancer may consider prophylactic removal of breasts or ovaries as a risk-reduction measure. This report describes uptake of risk-reduction mastectomy (RRM), risk-reduction oophorectomy (RRO), and related factors in 62 high-risk women who received genetic counseling. Seven (11%) participants underwent RRM and 13 (21%) underwent RRO. Of these women, 37% did not have BRCA testing, suggesting other factors influence decisions to undergo surgery. Women who had indicated (pre-genetic counseling) their intent not to have surgery chose not to have surgery. Information received during genetic counseling that women perceived as being most important for influencing risk-reduction surgery decisions was BRCA test result (positive or negative), followed by discussion of family cancer history. Reasons for indecision about risk-reduction surgery included genetic testing results, concerns about surgery, timing in life, and early menopause. The findings enhance our understanding of information that is helpful to women considering this surgery.
authors.affiliation: Arizona Cancer Center, University of Arizona, Tucson, 85724, USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Ray
authors.forename: Lois J
authors.initials: LJ
authors.lastname: Loescher
authors.forename: Molly
authors.initials: M
authors.lastname: Brewer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004252:DNA Mutational Analysis; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D005820:Genetic Testing / Q000523:psychology*; D005838:Genotype; D006801:Humans; D033182:Intention; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000517:prevention & control*; D010052:Ovariectomy / Q000523:psychology*; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D044767:Ubiquitin-Protein Ligases / Q000235:genetics*
chemical_list: D024682:BRCA2 Protein; C111164:BRAP protein, human; D044767:Ubiquitin-Protein Ligases