title: Long-term satisfaction and quality of life following risk reducing surgery in BRCA1/2 mutation carriers.
abstract: BACKGROUND
  As BRCA1/2 testing becomes more routine, questions remain about long-term satisfaction and quality of life following testing. Previously, we described long term distress and risk management outcomes among women with BRCA1/2 mutations. This study addresses positive psychological outcomes in BRCA1/2 carriers, describing decision satisfaction and quality of life in the years following testing.
  
  
  METHODS
  We evaluated satisfaction with testing and management decisions among 144 BRCA1/2 carriers. Prior to genetic testing, we assessed family history, sociodemographics and distress. At a mean of 5.3 years post-testing, we assessed management decisions, satisfaction with decisions and, among women with cancer, quality of life.
  
  
  RESULTS
  Overall, satisfaction with decision making was high. Women who had risk reducing mastectomy or oophorectomy were more satisfied with management decisions. Participants who obtained a risk reducing oophorectomy were more satisfied with their genetic testing decision. Among affected carriers, high pretest anxiety was associated with poorer quality of life and having had risk reducing mastectomy prior to testing was associated with better quality of life. The negative impact of pre-test anxiety was diminished among women who had mastectomies before testing.
  
  
  CONCLUSIONS
  BRCA1/2 carriers are satisfied with their testing and risk management decisions and report good quality of life years after testing. Having risk reducing surgery predicts increased satisfaction and improved quality of life.
authors.forename: Gillian W
authors.initials: GW
authors.lastname: Hooker
authors.forename: Lesley
authors.initials: L
authors.lastname: King
authors.forename: Lauren
authors.initials: L
authors.lastname: Vanhusen
authors.forename: Kristi
authors.initials: K
authors.lastname: Graves
authors.forename: Beth N
authors.initials: BN
authors.lastname: Peshkin
authors.forename: Claudine
authors.initials: C
authors.lastname: Isaacs
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Taylor
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Poggi
authors.affiliation: Department of Oncology, Jess and Mildred Fisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA. schwartm@georgetown.edu.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Schwartz