OBJECTIVE: Women who carry a BRCA1 or BRCA2 gene mutation face a risk of 
developing breast or ovarian cancer at an earlier age than women without such a 
mutation. Relatively little is known about the psychosocial 
consequences-especially regarding marriage and childbearing-in young women who 
test positive for one of these mutations.
METHODS: In 2006, participants were recruited from Web sites for women with 
breast cancer or BRCA gene mutations. Forty-four women ages 18 to 39 from 22 
states and Canada who had had genetic testing and were found to carry a BRCA 
mutation were interviewed by phone or e-mail. A qualitative, grounded theory 
analysis was performed on the data, focusing on the participants' being young 
and having had genetic testing for the BRCA mutation. The findings reported here 
focus on three characteristics of the participants-whether or not they were 
married, had children, or had a breast cancer diagnosis-and how those 
characteristics were affected by the women's knowledge of their genetic risk.
RESULTS: Among the 13 unmarried participants, issues of when to disclose 
information about their genetic risk in intimate relationships were discussed. 
Many of the 24 participants who had children reported "staying alive" for their 
children as a primary goal; the childless women reported an urgency to have 
children. Of the 21 who had a breast cancer diagnosis, the youngest was 24 years 
old, and several said knowledge of their genetic risk influenced their decision 
to have the unaffected breast removed prophylactically.
CONCLUSIONS: A sense of being different and not understood was expressed in 
these interviews. These findings suggest that nurses should be aware of 
psychosocial issues, especially those surrounding marriage and childbearing, in 
their interactions with young women who carry a BRCA1 or BRCA2 gene mutation.