• breast cancer
• ovarian cancer
• genetic cancer risk assessment

• GCRA, genetic cancer risk assessment
• COH, City of Hope
• CSPP, Cancer Screening & Prevention Program
• FDR, first degree relative
• SDR, second degree relative
• OC, oral contraceptives

About 5-10% of breast and ovarian cancers are the result of an autosomal dominant inherited predisposition, with a significant portion resulting from a germline mutation in the highly penetrant BRCA1 or BRCA2 genes.¹ The risk for breast cancer in women who carry a BRCA mutation is estimated to be 33-50% by the age of 50 and 56-85% by the age of 70,^1–4 and the risk of a second breast cancer may be as high as 60% over a woman's lifetime. The risk of ovarian cancer ranges from about 10-50%. Women are increasingly presenting for genetic cancer risk assessment (GCRA) services, wherein genetic testing and empirical data may be used to predict breast and ovarian cancer risk. Risk management options ranging from close surveillance to chemoprevention to prophylactic surgery are discussed as part of the GCRA consultation. While there is clearly a potential to benefit carefully selected and counselled subjects and family members who choose to undergo predisposition genetic testing,^5,6 numerous barriers exist to the appropriate application of this emerging technology.^7,8 Attention to the psychological implications of hereditary cancer including passing on a disease associated gene to one's children (transmission guilt) or alterations in family relationships are inherent in the counselling process. It is essential to understand the needs, beliefs, and values of women who seek GCRA services.⁹ The purpose of this pilot study was to ascertain the motivations and concerns of women presenting to a comprehensive cancer centre for GCRA in order to understand their needs better. The study findings provided valuable insights into women's concerns and served as the basis for an ongoing comprehensive evaluation of needs in a larger cohort.