Collective fear, individualized risk: The social and cultural context of genetic testing for breast cancer

The purpose of this article is to provide a critical examination of two asp ects of culture and biomedicine that have helped to shape the meaning and p ractice of genetic testing for breast cancer. These are: (1) the cultural c onstruction of fear of breast cancer, which has been fuelled in part by (2) the predominance of a 'risk' paradigm in contemporary biomedicine, The inc reasing elaboration and delineation of risk factors and risk numbers are in part intended to help women to contend with their fear of breast cancer. H owever, because there is no known cure or foolproof prevention for breast c ancer, risk designations bring with them recommendations for vigilant surve illance strategies and screening guidelines. We argue that these in effect exacerbate women's fears of breast cancer itself. The volatile combination of discourses of fear, risk and surveillance have significant ethical and s ocial consequences for women's lives and well-being. Genetic testing decisi ons are made within this context; if nurses understand this context they ca n play an important role in helping women to cope with the anxiety and fear of breast cancer risk.