Attitude towards prophylactic surgery and effects of genetic counselling in families with BRCA mutations

The intent of this study was to evaluate the effect that an awareness of be ing a BRCA1 or BRCA2 mutation carrier has on the attitude towards prophylac tic surgery and on developing depression symptoms. Thirty-five families wer e selected on the basis of previously detected BRCA1 or 2 mutations and 90 family members were given the appropriate questionnaires. Prophylactic mast ectomy (PM) was considered by 21% of the Austrian mutation carriers (29% af fected and 8% non-affected carriers), The majority of affected and non-affe cted carriers expected PM to impair the quality of their life. Fifty per ce nt would undergo prophylactic oophorectomy (53% affected and 46% nonaffecte d carriers). The self-rating depression scale indicated that following muta tion result disclosure the depression scores of carriers decreased (40 base line vs 38 after result disclosure, P = 0.3), whereas, for non-carriers, sc ores increased (36 baseline vs 40 after result disclosure, P = 0.05). We co nclude that information about carrier status is not associated with increas ed depression symptoms in mutation carriers. In non-carriers, depression sc ores increased slightly, probably reflecting survivor guilt. The option of having PM was associated with a negative impact on the quality of life and was declined by the majority of Austrian mutation carriers. (C) 2000 Cancer Research Campaign.