Intergenerational communication about inherited breast cancer susceptibility between mothers and their children

Abstract

5 ISSN 1758-1923 10.2217/BMT.13.70 © 2014 Future Medicine Ltd Breast Cancer Manage. (2014) 3(1), 5–8 Family communication about high-risk hereditary breast cancer genetic testing (e.g., genetic testing for BRCA1/2 mutations) and maternal disclosure of cancer genetic test results to minor children is a complex decision and raises a number of parenting challenges. Genetic counseling can help mitigate some of these challenges by providing patients with educational resources. The development of family communication decision-support tools can further augment patients’ genetic counseling experience by creating a more shared and informed framework for understanding communication choices and outcomes. Given the field’s growing propensity to genetically test multiple generations of relatives within the same family over time, adequately meeting the needs of patients seeking to engage in intergenerational cancer risk communication with children is an important and emerging area of behavioral oncology research. The advent of BRCA1/2 genetic testing for hereditary breast cancer risk in the mid1990s was ushered in by rapid advances in genome science and biotechnology, making it possible to provide both men and women with tangible information about cancer risks and for them to be better informed about subsequent risk-reduction options. These test results could, in turn, be disseminated by patients to their relatives to share information about their potential risk for developing cancer as well. Today, decades later, familial genetic testing has cascaded into second and third generations within some families, as children and even grandchildren of the ‘genetic testing pioneers’ begin presenting for genetic testing themselves. Additionally, the absolute number of probands, or first family member to be tested, has increased as BRCA1/2 genetic testing has become a routine aspect of practice [101]. More recently, a household-name celebrity’s announcement of her choice to undergo prophylactic mastectomy based on a positive BRCA test result brought a surge of awareness to cancer genetic testing and its potentially life-changing implications for patients and their relatives [1]. Concurrently, expanded policy recommendations