"It was an Emotional Baby": Previvors' Family Planning Decision-Making Styles about Hereditary Breast and Ovarian Cancer Risk

J Genet Couns. 2017 Dec;26(6):1301-1313. doi: 10.1007/s10897-017-0069-8. Epub 2017 Jan 30.

Abstract

Women who test positive for a BRCA genetic mutation are at an increased risk for developing hereditary breast and ovarian cancer and have a 50% chance of passing on their genetic mutation to their children. The purpose of this study was to investigate how women who test positive for a BRCA mutation but have not been diagnosed with cancer make decisions regarding family planning. Analysis of interviews with 20 women revealed they engage in logical and emotional decision-making styles. Although women want to be logical to reduce their hereditary cancer risk, emotions often complicate their decision-making. Women experience fear and worry about a future cancer diagnosis, yet also desire to create a family, particularly having children through natural conception. That is, women negotiate having preventative surgeries in a logical doctor-recommended timeframe but also organize those decisions around emotional desires of motherhood. Overall, this study demonstrates the complex decisions women who test positive for a BRCA mutation must make in regards to genetic testing timing, family planning, and overall quality of life.

Keywords: BRCA1, BRCA2; Decision-making; Disease risk; Family communication; Genetic risk; Genetic testing; Hereditary breast and ovarian cancer; Qualitative research.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / genetics
  • Breast Neoplasms / psychology*
  • Decision Making*
  • Family Planning Services
  • Female
  • Genes, BRCA1
  • Genetic Predisposition to Disease / psychology*
  • Genetic Testing*
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / psychology*
  • Quality of Life / psychology
  • Reproductive Behavior / psychology*

Supplementary concepts

  • Breast Cancer, Familial