This study (N=300) of women at high familial risk for breast and ovarian cancer aims to develop and assess a core intervention, based on state-of-the-art theory and research, to facilitate well-informed decisions for BRCA1/2 testing. In this procedure the genetic cancer testing candidate is helped to cognitively and emotionally anticipate scenarios about alternative potential outcomes of testing outlined in the informed consent process.

This project is designed to examine factors associated with the uptake of BRCA1/2 genetic testing and patients' medical management choices after learning their test results. The project will study patients' actual testing and medical management decisions in clinical practice and will examine the role of practitioner attitudes in those decisions. Data will be collected through interviews with patients who are offered BRCA1/2 testing, and through questionnaires to their practitioners.

This project is focused on the ways in which two diagnostic technologies--screening mammography and genetic testing--emerged, diffused, interacted with medical and social thought and values, and provoked controversy. The central research questions are: What are the factors that have led to the dramatic shift in beliefs about, and practices surrounding, breast cancer risk over the past fifty years? What have been the consequences?

The long term goal of this project is to improve patient understanding about breast cancer risk and genetic testing. This project will conduct a clinical trial to evaluate the effectiveness of a CD-ROM, called 'Counseling by Computer: Breast Cancer Risk and Genetic Testing', at educating women about breast cancer risk, and options and implications of genetic testing.

An increasing number of genetic carrier screening tests pose a challenge to adequate prenatal patient education. Clinic based computer patient education programs may be an effective response to this challenge. Before mounting a RCT to assess their effectiveness it is essential to study the feasibility of operating such programs in clinic settings. We propose a feasibility study.

Young women with a positive BRCA1 and/or BRCA2 mutation test face a potentially deadly genetic legacy at a developmental critical time in their lives. After learning they are at a high risk for hereditary breast and ovarian cancer (HBOC) these women

Candidate Dr. Nanibaa' Garrison is an Assistant Professor at Vanderbilt University on the tenure-track in the Center for Biomedical Ethics and Society with a primary appointment in the Department of Pediatrics and a secondary appointment in Anthropology. She completed a Ph.D. in genetics at Stanford University and postdoctoral fellowship at the Center for Integration of Research on Genetics & Ethics (CIRGE) within the Stanford Center for Biomedical Ethics (SCBE) with the support of an NIH F32 postdoctoral fellowship.

Prenatal genetic services have expanded at an extraordinary pace over the past 4 years with the development of fetal genome sequencing using cell-free placental DNA in maternal serum. Some commentators predict that this new technology, which allows for noninvasive determination of an increasingly wide range of maternal-fetal health conditions, will improve prenatal care, especially in lower-resource areas.