GENETIC-COUNSELING AND TESTING FOR BREAST-OVARIAN CANCER SUSCEPTIBILITY - WHAT DO WOMEN WANT

Purpose: To assess preferences for the content and process of genetic counseling and testing for breast-ovarian cancer susceptibility among women at high risk for breast cancer. Methods: Ninety-eight healthy wo men who had a family history of breast cancer in at least two first-de gree relatives participated in a structured telephone survey that eval uated preferences for type of provider and the content and process of pretest education and posttest genetic counseling. Results: Forty-two percent of women preferred that pretest education be delivered by a ge netic counselor, while 22% preferred an oncologist. This preference wa s positively associated with a desire to discuss psychosocial issues d uring the session (P = .001), For posttest counseling, 38% of women pr eferred an oncologist, while 20% preferred a genetic counselor. Howeve r, women who desired supportive counseling during this session were si gnificantly more likely to prefer a genetic counselor to an oncologist (P = .02). Fewer women wished to see a primary care physician or gyne cologist for pretest education (11%) or posttest counseling (22%). Wit h regard to the counseling process, 82% of women wished to self-refer for genetic counseling, but 63% desired advice and recommendations abo ut whether to be tested. Conclusion: When feasible, the optimal approa ch may be for oncologists to work with genetic counselors to provide p retest education and medical recommendations, Elicitation of patients' preferences may be useful to determine the level of counseling servic es needed. (C) 1998 by American Society of Clinical Oncology.