Julia, age 32, is BRCA1 positive and has decided to have both her ovaries removed. How should a genetic counselor respond to her decision?

The most appropriate response from a genetic counselor in this scenario would focus on the understanding of the BRCA1 mutation and its implications for cancer risk. The BRCA1 gene is well-known for its association with increased risks for both breast and ovarian cancer. Women who are BRCA1 positive have a significantly elevated lifetime risk for developing ovarian cancer, often estimated around 39% to 46%, alongside heightened risks for breast cancer.

In this context, when Julia, who is BRCA1 positive, decides to undergo oophorectomy (removal of ovaries) as a preventative measure, it is important for the counselor to clarify the nuances of her decision. One critical aspect is that while the BRCA1 mutation does substantially increase the risk of ovarian cancer, it does not imply that this risk is expressed to the exclusion of breast cancer. Both cancer types are relevant considerations, and understanding that removing her ovaries reduces her risk of ovarian cancer supports her decision while not dismissing the significant breast cancer risk still involved.

This means that as part of the counselor's role, it is essential to provide a comprehensive view of what carrying the BRCA1 mutation entails, particularly in terms of cancer risks, and to discuss the rationale behind surgery along with the reasons