Psychosocial context of the decision-making process and the consequences of preventive procedures in a patient with BRCA1 genetic mutation
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Institute of Psychology, University of Szczecin
Sylwia Natalia Michałowska   

Institute of Psychology, University of Szczecin
Submission date: 2019-10-06
Final revision date: 2020-04-14
Acceptance date: 2020-04-17
Online publication date: 2020-06-25
Publication date: 2020-06-25
Arch Psych Psych 2020;22(2):20–24
Background: Patients with a genetic mutation that increases the risk of cancer are often offered preventive surgery - mastectomy and adnaxectomy. The objective of this case report is to present the psychosocial context of the decision to perform prophylactic breast and ovarian removal surgery and the consequences of the indicated procedures on the example of a patient with the BRCA1 genetic mutation, to adapt educational activities and support for patients. Case presentation: Patient with BRCA1 genetic mutation, without cancer diagnosis - now and in the past. Cancers occurred in the family. Due to high cancer risk, in 2018 performed two preventive procedures - mastectomy and adnaxectomy. The decision to carry out preventive surgical procedures made two years after receiving a recommendation from a geneticist, which was due to the family situation and the patient's responsibilities. The decision was associated with a special mental state which means that the risk of cancer may contribute to the patient's feeling of fear or recurring concerns about their health and requires meeting specific support needs. Conclusions: Patient needs covered educational or emotional and social aspects, but also support provided by qualified specialists and medical staff. The patient's experience described indicates that specialist psychological help is needed not only at the stage preceding the decision to carry out preventive surgical procedures, but also after their execution, because it is associated with changes that affect the patient's daily life and, consequently, her psychophysical condition.