The risk of breast cancer is on most every woman's mind. For some, however, the risk is greater than for others because of what is known as personal or family high-risk factors.

For example, women who previously had breast or ovarian cancer, or who have a family history of such cancers (especially if it occurred in first- or second-degree relatives), should be considered high risk. Some families even carry a breast cancer mutation in their genes (detected in their blood cells), called BRCA1 or BRCA2.

In a new study, researchers evaluated the family history and risk of 83 women. Of these study participants, 31 women were so concerned about their high risk for breast cancer that they requested prophylactic mastectomy (breast tissue removal). With such surgery, these patients hoped to significantly reduce their subsequent risk of cancer.

The study was led by Katherine T. Morris, MD, of the department of surgery, Oregon Health Sciences University and Legacy Cancer Services in Portland, and reported in a recent issue of American Journal of Surgery (Vol. 182: 431-433).

In an effort to clarify the concerns of patients and balance them with scientific evidence, the surgeon-researchers enlisted the help of medical geneticists. Prior to any surgery, they carefully looked at each patient's own medical history as well as her family's for any significant cancer risk.

As a result of understanding the full profile of each patient, and balancing concerns with current medical evidence, the geneticists were able to adjust patients' fears with the true risk. Following this genetic evaluation, only 18 women from the initial group of 31 selecting prophylactic surgery decided to proceed with the surgery.

Fear and limited information is not a good combination. Women seeking ways to reduce their risk of breast cancer can first consider an appropriate genetic consultation before they proceed with prophylactic surgery.

And, information available to women on the topic of breast cancer risk is becoming more available. Genetic information on cancer risk will continue to accumulate at increasing speed as new biotechnologies will make such analysis more accurate and available.

This growing knowledge will need to be interpreted and shared with all medical professionals as well as patients. A medical geneticist will likely serve a greater role as an interpreter of cancer risk for patients as well as educator to other medical professionals.