Males at-risk for the BRCA1-gene, the psychological impact

In recent literature the psychological impact of predictive DNA-testing for Hereditary Breast and Ovarian Cancer (HBOC) for male individuals at-risk has not been considered. We have observed that confrontation with the hereditary nature of breast/ovarian cancer does have a psychological impact on males at-risk. From the first Dutch family for whom predictive DNA-testing for HBOC became an option, four males started the testing protocol with the inclusion of pre-test genetic and psychological counselling and psychological follow-up. They all postponed appointments and only one took the test. During counselling of the men, the main focus of attention was on the impact of the past and future (possible) deaths and serious illnesses of female relatives. They tended to deny or minimise the emotional impact of the occurrence of HBOC in their personal life and their future. They avoided discussion about their emotions and focused upon the medical implications of the disorder for their female relatives. It is important to understand the underlying conflicts which lead to warding off the test in males at risk, in order to offer adequate genetic counselling and to enable the males to better cope with the hereditary disorder in the family