Salute e Società, XXII, 1/2023, ISSN 1723-9427, ISSNe 1972-4845 Doi: 10.3280/SES2023-001011 OFF TOPIC You definitely need a mastectomy if you are mutated! Experiencing breast cancer among genetic responsibilities and risk-reducing practices Barbara Morsello * Genetics and predictive tests are changing breast cancer prevention, both in terms of subjec- tive experience and risk reducing practices. The aim of the article is to address two main research questions: What does the genetic information mean for subjects? How does preven- tion and risk-reducing practice change in relation to genetic information? Through qualitative research on breast cancer experience conducted in Italy at the National Cancer Institute of Rome, it was possible to answer these questions by including women who received a genetic response for the BRCA mutation. What emerges is that the genetic information shapes risk- reducing practice, fostering genetic responsibilities within the family. This seems to encour- age woman to perceive radical risk-reducing strategies such, as a mastectomy or oophorec- tomy, as the main – and often mandatory – solution to face breast cancer risk thereby under- estimating the health risks and psychological burden involved in preventive surgery. Keywords: BRCA; breast cancer; risk; prevention; genetics; mastectomy. 1. Context Breast cancer has been completely reconfigured by clinical predictive tests eliciting the emergence of new bio-clinical entities (Keating et al., 2016), as the case of BRCA genes mutations, shaping prevention, both in terms of subjective experience and social practices (Prainsack et al., 2014). Individuals with a positive test for a BRCA mutation are highly predisposed to developing hereditary breast and ovarian cancer (HBOC) 1 and these pa- tients face preventative health decisions (Ross Arguedas et al., 2020) such as undergoing a prophylactic bilateral mastectomy or getting screened fre- quently. “Being positive” give the “permission to be ill” (Jutel, 2009) or “proto-ill” (Gillespie, 2015) and provides a cultural expression of what soci- ety is prepared to accept as normal and what should be treated. * Università di Padova. barbara.morsello@unipd.it 1 Individuals with a BRCA1 gene mutation run a 65% risk of getting sick, in contrast to the 40% risk of those with BRCA2 mutation (Melchor, Benitez, 2013). Copyright © FrancoAngeli. E’ vietata la Riproduzione dell’opera e la sua messa a disposizione di terzi, sia in forma gratuita sia a pagamento. Il documento può essere concesso in licenza individuale o istituzionale.