Sharon Osbourne's preventive mastectomy
6th November 2012 - The former X-Factor judge Sharon Osbourne has had a double mastectomy after being told she carries genes which increase her risk of breast cancer.
She had colon cancer 10 years ago. "The odds are not in my favour," she told Hello! magazine.
"I didn't want to live under that cloud: I decided to just take everything off, and had a double mastectomy."
Around 48,000 women get breast cancer in Britain each year.
Genetic testing is offered for women with a higher risk of breast cancer, such as having close family relatives with cancer. The test screens for faulty genes called BRCA1 and BRCA2.
Preventive mastectomy decision making
To find out about the decisions facing a women who is told she has a genetic risk of breast cancer, BootsWebMD spoke to Dr Caitlin Palframan, policy manager at Breakthrough Breast Cancer.
"I think it's always a difficult decision. The NHS offers free genetic counselling to women in this situation who have a very high risk of developing breast cancer.
"That counselling will take them through what their options are. This kind of surgery is not the only option. Some women will take a more watchful waiting approach. They might opt for extra screening instead which gives them the best chance of detecting breast cancer at an early stage."
Weighing-up the options
Dr Palframan says a genetic counsellor will discuss the options with a woman: "How high their risk actually is. What risk reduction is associated with having this kind of surgery. How it might make them feel about their bodies.
"All kinds of things need to be considered and different people will rate different things in a different way. Some women might have more concerns about how they'll look than others. It's a really personal decision and the genetic counselling is there to guide women through that decision."
A woman will usually be referred for genetic screening via her GP because of concerns about family history.
"Once they are there, they'll have their family history taken again. They'll work out how high the risk is that they might carry one of these genetic faults," Dr Palframan says.
"Then they'll talk to them about the genetic testing process. What the results could be. What the different results would mean for the person. Once the genetic counsellor is satisfied the person has made an informed choice, and knows what's involved, blood tests will be sent off for genetic testing."
Getting the genetic test results
The results will be known in two to eight weeks. "Then they'll have a session with a counsellor to discuss what the results actually are, what they mean for them and options available to them."
The decision on the next steps could be made at that meeting or later: "It depends on the woman. Generally slow and steady is the approach that's taken for these things to make sure that people really have a chance to think about what the results mean for them," Dr Palframan says.