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Accuracy in risk understanding among BRCA1/2-mutation carriers.

Dorothee Speiser1, Felix G Rebitschek2, Markus A Feufel3

  • 1Department of Gynecology with Breast Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.

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Summary

Many BRCA1/2-mutation carriers overestimate their 10-year cancer risk. Accurate risk understanding is crucial for informed decisions about preventive measures and avoiding unnecessary interventions.

Keywords:
BRCA1/2 gene mutationGenetic counselingRisk accuracyRisk perceptionSubjective risk estimation

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Area of Science:

  • Genetics
  • Oncology
  • Risk Communication

Background:

  • BRCA1/2 mutations significantly elevate cancer risk.
  • Accurate 10-year risk perception is vital for BRCA carriers making decisions about risk-reducing strategies.
  • Understanding subjective risk estimates is key to effective prevention counseling.

Purpose of the Study:

  • To assess the accuracy of women's 10-year subjective risk estimates for breast and ovarian cancer.
  • To evaluate the role of sociodemographic and psychosocial factors in risk perception accuracy.
  • To inform strategies for improving risk communication in genetic counseling.

Main Methods:

  • 59 and 52 BRCA1/2 mutation carriers provided subjective 10-year cancer risk estimates.
  • Risk estimates were compared against communicated objective cancer risks.
  • Sociodemographic and psychosocial variables were collected and analyzed.

Main Results:

  • Over half of counselees overestimated their 10-year risk for both breast cancer (53.2%) and ovarian cancer (51.9%).
  • A significant proportion also underestimated their risk for breast cancer (22.6%) and ovarian cancer (5.6%).
  • No significant association was found between risk accuracy and demographic factors, prior diagnoses, or prophylactic surgeries.

Conclusions:

  • Current genetic counseling practices do not ensure accurate risk perception for BRCA mutation carriers.
  • Counselors must actively assess and correct risk overestimations.
  • Improving risk communication is essential for informed decision-making and appropriate preventive actions.