ATTITUDE TOWARDS PROPHYLACTIC SURGERY AND EFFECTS OF GENETIC COUNSELLING IN FAMILIES WITH BRCA MUTATIONS. R. Moeslinger¹, T. Wagner¹, G. Langbauer¹, Austrian Hereditary Breast and Ovarian Cancer Group¹, E. Fleischmann¹, A. Autherith², A. Friedmann³, T. Helbich⁴, P. Oefner⁵. 1) Dept OB/GYN, Div Senology, Vienna, Austria; 2) Department of Statistics, University of Vienna; 3) Department of Psychiatry, University of Vienna; 4) Department of Radiology, University of Vienna; 5) Stanford DNA Sequencing and Technology Center.
   The intent of this study was to evaluate the effect that awareness of being a BRCA1 or BRCA2 mutation carrier has on the attitude towards prophylactic surgery and on developing depression symptoms,. Sixty three families were selected on the basis of previously detected BRCA1 or 2 mutations and 142 family members were given the appropriate questionnaires. Prophylactic mastectomy (PM) was considered by 23% of the Austrian mutation carriers (28% affected and 17% non-affected carriers). The majority of affected and non-affected carriers expected PM to impair the quality of their life. Sixty percent would undergo prophylactic oophorectomy (68% affected and 50% non-affected carriers). The self-rating depression scale indicated that following mutation result disclosure the depression scores of carriers decreased (40 baseline vs. 39 after result disclosure, p=0.5), whereas, for non-carriers, scores increased (37 baseline vs. 39 after result disclosure, p=0.8). However in affected carriers only 4% have performed PM respectively only 17% PO and in non-affected carriers these percentages were even lower: Only 2% performed PM and 13% PO. We conclude, that information about carrier status is not associated with increased depression symptoms in mutation carriers. In non-carriers depression scores increased slightly, probably reflecting survivor guilt. The option of having PM was associated with a negative impact on the quality of life and was declined by the majority of Austrian mutation carriers.