Attitude towards prophylactic surgery and effects of genetic counselling in families with BRCA mutations. Austrian Hereditary Breast and Ovarian Cancer Group

Br J Cancer. 2000 Apr;82(7):1249-53. doi: 10.1054/bjoc.1999.1086.


The intent of this study was to evaluate the effect that an awareness of being a BRCA1 or BRCA2 mutation carrier has on the attitude towards prophylactic surgery and on developing depression symptoms. Thirty-five families were selected on the basis of previously detected BRCA1 or 2 mutations and 90 family members were given the appropriate questionnaires. Prophylactic mastectomy (PM) was considered by 21% of the Austrian mutation carriers (29% affected and 8% non-affected carriers). The majority of affected and non-affected carriers expected PM to impair the quality of their life. Fifty per cent would undergo prophylactic oophorectomy (53% affected and 46% non-affected carriers). The self-rating depression scale indicated that following mutation result disclosure the depression scores of carriers decreased (40 baseline vs 38 after result disclosure, P = 0.3), whereas, for non-carriers, scores increased (36 baseline vs 40 after result disclosure, P = 0.05). We conclude that information about carrier status is not associated with increased depression symptoms in mutation carriers. In non-carriers, depression scores 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude to Health*
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / prevention & control
  • Depression
  • Female
  • Genes, BRCA1 / genetics*
  • Genetic Counseling*
  • Genetic Predisposition to Disease*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Mastectomy / psychology*
  • Middle Aged
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / prevention & control
  • Ovariectomy / psychology
  • Pedigree
  • Quality of Life