Danger zones: risk perceptions of young women from families with hereditary breast and ovarian cancer.

Genetic testing for hereditary breast and ovarian cancer (HBOC) is predictive, not prophetic. Families frequently rely on multigenerational stories to make sense of the inherent ambiguity as they face medical decisions and navigate life's journeys. This study asks young women with elevated genetic risk how family histories with cancer and experiences with health professionals inform their beliefs about risk and susceptibility to HBOC. Twenty-two women aged 22-36 who carry a BRCA mutation completed illness genograms and open-ended interviews. Transcripts were analyzed using a narrative tool that emphasizes the use of voice to highlight key relationships and meaning structures. Findings reveal that beliefs about risk are more firmly grounded in family experiences with cancer than in biomedical research. Pervasive meanings included (1) the presence of "danger zones," specific ages at which cancer risk was believed to increase dramatically, and (2) the experience of "the wait and the worry," in which participants felt increased urgency to achieve family development goals (i.e., child bearing) and limited control over environmental factors influencing when these goals could be met (i.e., meeting a life partner). A clinical case example and research implications are discussed.