Discovery of mutations in the breast and ovarian cancer susceptibility genes 
BRCA1 and BRCA2 can have emotional consequences for both the tested individual 
and his or her relatives. This secondary analysis study investigated how BRCA 
testing impacts family dynamics and relationships. For the original study, a 
grounded theory inquiry, participants were recruited from a hereditary 
breast/ovarian cancer syndrome support website and open-ended interviews were 
performed asking about individual and family experiences after BRCA testing. All 
12 participants whose interviews were included in the secondary analysis had a 
BRCA mutation. For the secondary analysis, thematic analysis was conducted and 
revealed three main themes characterizing the effect of BRCA testing on family 
relationships: 1. That the first in the family to have testing or seek genetic 
counseling takes on a special family role that can be difficult for them; 2. 
That discussions in the family often change; and 3. That individuals may feel 
more or less connected to certain family members. These changes seemed to relate 
to family cancer history, relationships, coping strategies, communication 
patterns, and mutation status. Genetic counselors might find it useful to 
explore these issues in order to prepare clients before BRCA testing and to 
support them through shifts in family dynamics after disclosure of results.