title: Time to decide about risk-reducing mastectomy: a case series of BRCA1/2 gene mutation carriers.
abstract: BACKGROUND
  The purpose of this research was to explore women's decision-making experiences related to the option of risk-reducing mastectomy (RM), using a case series of three women who are carriers of a BRCA1/2 gene mutation.
  
  
  METHODS
  Data was collected in a pilot study that assessed the response of women to an information booklet about RM and decision-making support strategies. A detailed analysis of three women's descriptions of their decision-making processes and outcomes was conducted.
  
  
  RESULTS
  All three women were carriers of a BRCA1/2 gene mutation and, although undecided, were leaning towards RM when initially assessed. Each woman reported a different RM decision outcome at last follow-up. Case #1 decided not to have RM, stating that RM was "too radical" and early detection methods were an effective strategy for dealing with breast cancer risk. Case #2 remained undecided about RM and, over time, she became less prepared to make a decision because she felt she did not have sufficient information about surgical effects. Case #3 had undergone RM by the time of her second follow-up interview and reported that she felt "a load off (her) mind now".
  
  
  CONCLUSIONS
  RM decision making may shift over time and require decision support over an extended period.
authors.affiliation: Hereditary Cancer Program, BC Cancer Agency, Vancouver, BC, Canada. mmccullum@bccancer.bc.ca
authors.forename: Mary
authors.initials: M
authors.lastname: McCullum
authors.forename: Joan L
authors.initials: JL
authors.lastname: Bottorff
authors.forename: Mary
authors.initials: M
authors.lastname: Kelly
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Kieffer
authors.forename: Lynda G
authors.initials: LG
authors.lastname: Balneaves