Grant: Operating Grant

Women with a BRCA1 or BRCA2 mutation have an 80% lifetime risk of breast cancer and a 40% lifetime risk of ovarian cancer. In women with a BRCA mutation, prophylactic bilateral salpingo-oophorectomy (BSO) (preventive removal of the fallopian tubes and ovaries) reduces the risks of both breast and ovarian cancer and reduces mortality by 70%. Based on this profound reduction in cancer risk and mortality, BSO is now recommended to all women in Canada with a BRCA mutation at the age of 35 years or above. Nevertheless, approximately 45% of Canadian women with a BRCA mutation have not had a BSO. An intervention is required to increase uptake. In this study will determine if, among BRCA1 and BRCA2 carriers with intact ovaries, a follow-up telephone genetic counseling session increases the uptake of BSO compared to women who receive usual care. In addition, we will determine to what extent access to preventive gynecologic surgery in various communities across Canada is a factor in a woman not having a BSO and to determine if there is an effect of follow-up telephone genetic counseling on decisional conflict and knowledge in women with a BRCA mutation. This will be a randomized controlled trial. Women will be randomized to a follow-up telephone genetic counseling session (TGC) or to usual care and then followed at 12 to determine if they have had a BSO and they will complete a questionnaire regarding reasons why they did or didn't have the oophorectomy. The study analysis will compare the uptake of BSO in the one year period following telephone genetic counselling with that of women receiving usual care. This study will allow for the translation of research findings on cancer prevention into the clinical setting, with the potential to decrease mortality in this group of women.