Anticipatory loss and early mastectomy for young female BRCA1/2 mutation carriers.

Young women who carry BRCA1/2 mutations face difficult decisions in managing their hereditary breast/ovarian cancer risk. Through this National Cancer Institute study, we sought to understand the process by which some young women choose risk-reducing bilateral mastectomy (RRBM) instead of alternative risk-management options. Data indicate that electing to undergo RRBM, although difficult, is experienced as a way to sidestep potentially devastating outcomes, such as stressful and costly high-risk screening, chemotherapy or radiation, or putting loved ones through the challenges of a cancer diagnosis. The decision to pursue RRBM is often the product of screening fatigue, encouragement from loved ones, and/or a sense of urgency to put one's high-risk period behind one. By understanding how young carriers make decisions about surgical risk reduction, providers can better guide, counsel, and support patients in the important tasks surrounding this life-changing medical decision, thereby helping to increase the duration and quality of their lives.