Jessica (aged 32) is BRCA1 positive, which is known to greatly increase the risk for breast and ovarian cancer. She was tested because her mother, who had ovarian cancer, was BRCA1 positive. Jessica has decided to have both of her ovaries removed because she believes that, in her family, being BRCA1 positive increases the risk for ovarian cancer only.
How should a genetic counselor respond to Jessica's statement?
a. Encourage her to consider a bilateral mastectomy.
b. Discuss Jessica's responsibility to inform all the other female members of her family about her BRCA1 status and cancer risk.
c. Accept Jessica's explanation as a manifestation of her autonomy and remain nondirective in the interactions with her.
d. Clarify that a BRCA1 mutation does not preferentially express ovarian cancer over breast cancer in any given family.
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