DECISION-MAKING ABOUT GENETIC TESTING AMONG WOMEN AT FAMILIAL RISK FOR BREAST-CANCER

Objective: Recent identification of the breast-ovarian cancer suscepti bility gene BRCA1 and the breast cancer susceptibility gene BRCA2 have raised the possibility of clinical genetic testing for breast cancer susceptibility. This study examined decision-making about future susce ptibility testing among women at familial risk for breast cancer. Base d on the transtheoretical model, it was hypothesized that readiness to undergo testing would be related to the ratio between the perceived a dvantages (pros) and disadvantages (cons) of learning one's susceptibi lity status. Methods: Seventy-four women with one or more first-degree relatives with breast cancer were recruited before a routine mammogra m. Participants completed measures assessing readiness to undergo test ing, perceived pros and cons of testing, and perceived breast cancer r isk. Family history data was used to calculate empiric genetic risk of developing breast cancer. Results: Forty-six per cent of participants planned to seek genetic testing as soon as possible, 35% planned to s eek testing in the future, and 19% did not plan to seek testing. As ex pected, greater readiness to undergo testing was associated with a pos itive decisional balance (pros > cons). Older age and greater perceive d risk (but not empiric risk) also were associated with greater readin ess. Conclusion: The readiness of many women to seek breast cancer sus ceptibility testing can be attributed, in large part, to their percept ions that the advantages outweigh the disadvantages. Examination of th ese perceptions suggests that notification of carrier status may have significant effects on women's psychological well-being and breast can cer surveillance and prevention behaviors.