Ray Jessica A, Loescher Lois J, Brewer Molly
Arizona Cancer Center, University of Arizona, Tucson, 85724, USA.
J Genet Couns. 2005 Dec;14(6):473-84. doi: 10.1007/s10897-005-5833-5.
Women at greatest risk for hereditary breast and ovarian cancer may consider prophylactic removal of breasts or ovaries as a risk-reduction measure. This report describes uptake of risk-reduction mastectomy (RRM), risk-reduction oophorectomy (RRO), and related factors in 62 high-risk women who received genetic counseling. Seven (11%) participants underwent RRM and 13 (21%) underwent RRO. Of these women, 37% did not have BRCA testing, suggesting other factors influence decisions to undergo surgery. Women who had indicated (pre-genetic counseling) their intent not to have surgery chose not to have surgery. Information received during genetic counseling that women perceived as being most important for influencing risk-reduction surgery decisions was BRCA test result (positive or negative), followed by discussion of family cancer history. Reasons for indecision about risk-reduction surgery included genetic testing results, concerns about surgery, timing in life, and early menopause. The findings enhance our understanding of information that is helpful to women considering this surgery.
患遗传性乳腺癌和卵巢癌风险最高的女性可考虑预防性切除乳房或卵巢作为降低风险的措施。本报告描述了62名接受遗传咨询的高危女性中降低风险乳房切除术（RRM）、降低风险卵巢切除术（RRO）的接受情况及相关因素。7名（11%）参与者接受了RRM，13名（21%）接受了RRO。在这些女性中，37%未进行BRCA检测，这表明其他因素影响手术决策。那些（在遗传咨询前）表示不打算做手术的女性选择不做手术。女性认为在遗传咨询期间获得的对影响降低风险手术决策最重要的信息是BRCA检测结果（阳性或阴性），其次是家族癌症病史的讨论。对降低风险手术犹豫不决的原因包括基因检测结果、对手术的担忧、生活时机以及过早绝经。这些发现增进了我们对有助于考虑此类手术的女性的信息的理解。
