Some decisions just can't be rushed. And that is certainly true for women who face tough surgical choices after learning they have an extremely high chance of getting breast and ovarian cancer.
Women born with mutations in the BRCA1 or BRCA2 genes have up to an 85-per-cent lifetime risk of developing these cancers. Unfortunately, the best medical defence is fairly extreme - the removal of the breasts (mastectomy) and ovaries (oophorectomy).
A new British study suggests some women may mull over their options for many years after receiving the results of the genetic test.
"There was an assumption that women would make up their minds within the first year or so ... and it's true a bunch do opt for surgery in that time," lead researcher Gareth Evans of the University of Manchester said in an interview.
"But there is a significant portion of women who spend quite some time making the decision."
Most previous studies have focused on the actions of women relatively soon after they learn their test results. But Dr. Evans's continuing research has followed a group of 211 women for seven years. Over all, 40 per cent of them have chosen to undergo mastectomies and 45 per cent have opted for oophorectomies. And even after seven years, some women are still coming around to the idea of surgery, he said.
"Clinical experience indicates that many women require a longer period of reflection, information-gathering and consultation before deciding to proceed to risk-reducing surgery," Dr. Evans and colleagues conclude in the study published in the journal Cancer Epidemiology, Biomarkers & Prevention. "Life stage, occupation and educational commitments may lead to a deferment for some women."
For instance, some young women put off the removal of their ovaries until after they have had children, Dr. Evans noted.
Other women, after teetering on the brink for years, finally opt for surgery after a close family member is diagnosed with cancer or dies from the disease.
In some respects, the study serves as a window on the future as more and more genetic tests become available for a wider variety of diseases. Patients may take years to react. As Dr. Evans puts it: "Decisions are not set in stone" once the tests result are in.