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October 9, 1996

Genetic Testing of Families With Hereditary Diseases

Author Affiliations

University of Chicago Medical Center Chicago, Ill

JAMA. 1996;276(14):1138-1139. doi:10.1001/jama.1996.03540140026016

To the Editor.  —Dr Lerman and colleagues1 recently provided data on the uptake of BRCA1 testing in adult members of families with BRCA1-linked hereditary breast-ovarian cancer. However, in their discussion, the authors underscored the value of personal access to genetic education in helping patients form opinions about testing. It is not surprising that only 43% of their study subjects requested BRCA1 results, probably because of the counseling model used.2 In my experience, the relationships within some families are so strained that individual members would rather not interact with some of their relatives. What is remarkable about the study by Lerman et al is that 115 (99%) of 116 individuals who participated in pretest education elected to receive their test results. These data strengthen the argument for personalized counseling.3A recent review of our Cancer Risk Clinic program identified access to counseling and education as one of