Both of Susie’s parents died from breast cancer. Susie tested positive for the BRCA1 gene, the BRCA2 gene, and HPV; however, she does not have any cancer cells in her body or any signs or symptoms. Susie just called you and told you that she has decided to undergo a double radical mastectomy to remove both of her breasts and a complete hysterectomy to remove her ovaries, uterus, and cervix. Susie is 29 years old, has no children, and is not married. She is extremely scared

I'm sorry to hear that Susie is going through such a difficult situation. It's understandable that she may be feeling scared given her family history and positive genetic testing results. It's important to approach this decision with proper medical guidance and support.

I would strongly recommend that Susie consults with healthcare professionals such as genetic counselors, oncologists, and gynecologists who specialize in cancer risk management. They will be able to provide her with personalized information and guidance based on her specific situation. They will take into account her family history, genetic test results, overall health, and any other relevant factors.

Here is an outline of the steps she could take to get the necessary guidance:

1. Find a genetics counselor: Susie can start by finding a qualified genetic counselor who can explain her test results in detail. They will help her understand her risk factors, the meaning of the positive genetic test results, and discuss any available preventative options.

2. Consult with an oncologist: Susie should schedule an appointment with an oncologist who specializes in breast cancer. The oncologist will review Susie's case, assess her risk, and discuss the available options for prevention and risk reduction.

3. Seek a gynecologist's opinion: Susie should consult with a gynecologist who specializes in cancer risk management. They will evaluate her risk for gynecological cancers such as ovarian cancer, discuss options for surveillance and prevention, and weigh the benefits and risks of a hysterectomy.

4. Gather information about risk reduction options: Susie should ask her healthcare team to explain all the preventive measures available to her. This may include increased surveillance, chemoprevention, or prophylactic surgeries like mastectomy or hysterectomy. They can also guide her on the potential benefits, risks, and long-term implications of these interventions.

5. Evaluate emotional and psychological support: Susie should consider seeking support from trusted friends, family members, support groups, or therapy to help her cope with the emotional challenges she may face during this decision-making process and afterward.

It's important for Susie to remember that this decision is very personal and ultimately hers to make. By consulting with a team of specialists and gathering as much information as possible, she can make a more informed decision that aligns with her overall well-being and values.