Risk‐Reduction Surgery Decisions in High‐Risk Women Seen for Genetic Counseling
Open accessAbstract
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.
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The information provided at the family cancer clinic is complex, thus stressing the importance of repetitive but consistent information regarding cancer risk by the different clinicians involved.
“These results are consistent with the findings of others [9,18,19], and indicate that the information provided at the family cancer clinic is complex, thus stressing the importance of repetitive but consistent information regarding the cancer risk by the different clinicians involved.”
From Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy (2009) · cites this paper as [18]
The section ‘Genetic Counseling Information that Influenced Risk-Reduction Surgery Decisions’ describes uncertainty in interpreting genetic test results and emphasizes comprehensive cancer-risk assessment and information from the counseling team. It does not say that clinicians should repeat cancer-risk information consistently; that recommendation goes beyond what this source supports. Page numbers were not available in our copy. (LLM, conf=0.83)
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Roukos, D. H. (2011) · doi:10.2217/9781780840680
Eltahir, Y. M. (2022) · doi:10.33612/diss.204256365
Waggoner, R. M., Ricker, C. N., Nie, Q., Guo, X. M., Comeaux, J. G., Chang, E. Y., Gutiérrez, N., Hernandez, D., Nguyen, A., Garcia, I., et al. (2026) · Gynecologic Oncology · doi:10.1016/j.ygyno.2026.04.017
Breast Cancer Genetics and Risk Assessment
Shannon, K. M., & Chittenden, A. B. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1267-4_1
Surgical Management of Hereditary Breast and Ovarian Cancer
Specht, M. C., Carmen, M. G. D., & Smith, B. L. (2010) · Springer eBooks · doi:10.1007/978-0-387-93846-2_4
- Authors
- Ray, J. A., Loescher, L. J., & Brewer, M.
- Affiliations
- University of Arizona (US)
- Corresponding author
- Loescher, Lois J.
- ORCID
- Loescher, Lois J.
- Venue
- Journal of Genetic Counseling
- Publisher
- Wiley
- Published
- 2005-12
- Volume
- 14
- Issue
- 6
- Pages
- 473-484
- ISSN
- 1059-7700 (ISSN-L)
- 1573-3599
- OpenAlex
- W2082617004
- Cited by
- 53
- References
- 46
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2020: 3 · 2018: 1 · 2016: 3 · 2014: 7 · 2013: 4 · 2012: 2
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Genetic Counseling (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Arizona Cancer Center
- Oncology Nursing Foundation
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- prophylactic mastectomy, prophylactic oophorectomy, hereditary breast and ovarian cancer, BRCA testing, genetic counseling, surgical decision-making, high-risk women, family history of cancer, early menopause, patient decision factors
- MeSH terms
- Adult, Aged, Aged, 80 and over, Attitude to Health, Breast Neoplasms, Cross-Sectional Studies, Decision Making, DNA Mutational Analysis, Female, Genetic Counseling, Genetic Testing, Genotype, Humans, Mastectomy, Middle Aged, Ovarian Neoplasms, Ovariectomy, Prospective Studies, BRCA2 Protein, Intention, Risk Reduction Behavior, Ubiquitin-Protein Ligases
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