Genetic counseling impacts decision for prophylactic surgery for patients perceived to be at high risk for breast cancer

Background: This study addresses the impact a comprehensive genetic counsel ing program had on women considering prophylactic mastectomy or oophorectom y. Methods: Sixty patients underwent detailed family evaluation and risk was e stimated. Recommendations were made regarding testing. Ramifications of tes ting were discussed in detail. Results: Thirty-one women (37%) were considering prophylactic surgery belie ving themselves to be at high risk. Of these, 23 had testing recommended. S even patients proceeded with prophylactic surgery based solely on high risk assessment. Ten women were tested; five were positive. Three patients proc eeded with prophylactic surgery despite a negative test. One decided agains t surgery despite a positive test. After counseling, prophylactic surgery w as performed in just over half the initial candidates. Conclusions: Breast cancer risk estimation and genetic evaluation can be co mplex. Comprehensive genetic risk assessment programs can play a significan t role in the management of patients considering prophylactic surgery for p erceived high risk. (C) 2001 Excerpta Medica, Inc. All rights reserved.