Table 2.
Parental Concerns and Advice Concerning Talking to Children about Maternal BRCA1/2 Test Result
| Parental Concern | Theme of Parental Advice |
|---|---|
| Burden on parents of not telling | Assess children’s vulnerabilities. There is relief in telling |
| Fear child may overhear test result | Tell at earliest point when parents are comfortable |
| Couple needs to discuss telling children | Though good to plan, also tolerable if one parent spontaneously tells children at opportune moment |
| Prophylactic surgery may prompt telling test result | Children can understand, but, especially daughters may need time to adjust to this news |
| Question own ability to convey proper information | Get help from well-informed relatives or by asking professionals for advice about informing children |
| Couple impact | Test result disclosure may re-arouse parents’ fears about maternal illness, which merits discussion between the couple. |
| Indecision about how to tell children | Telling all children together may not recognize differences in strengths, vulnerabilities of each child or differences age makes in consideration of implications for screening or risk-reducing options |
| Desire to be honest, but not overwhelming to children | Initial talk doesn’t have to tell all about BRCA1/2. Can introduce, ask what questions child has and try to answer, and encourage on- going dialogue. |
| Uncertainty about child’s maturity to understand genetic result and implications. | Parents differed widely on what ages they considered children had sufficient maturity to handle receipt of BRCA1/2 test result |
| Concern about distressing child | Important to stress positive, constructive ways in which genetic information can reduce family illness burden in the future; Assess individually. |
| Children need preparation for possible future maternal cancer diagnosis | Telling about positive or UI maternal test result may immunize children, help prepare them for and reduce shock of future maternal illness. |
| Parental decision is not to tell children | Planning for future telling of children may reduce parental anxiety; some parents make plans for post–death informing of children |