Conflict between values and technology: perceptions of preimplantation genetic diagnosis among women at increased risk for hereditary breast and ovarian cancer Gwendolyn P. Quinn Æ Susan T. Vadaparampil Æ Lindsey M. King Æ Cheryl A. Miree Æ Sue Friedman Published online: 25 June 2009 Ó Springer Science+Business Media B.V. 2009 Abstract Members of families affected by hereditary cancer are often concerned about passing on risk to off- spring. Preimplantation genetic diagnosis is a procedure performed to identify embryos that inherit mutations placing them at risk for hereditary conditions. Little is known about attitudes toward the use of this technology among individuals at risk for hereditary breast and ovarian cancer. We sought to determine high risk women’s atti- tudes. This study is a qualitative examination of comments from women who participated in an online survey regard- ing knowledge and attitudes of preimplantation genetic diagnosis among individuals affected by hereditary breast and ovarian cancer. More than half the respondents held less favorable attitudes about the use of preimplantation genetic diagnosis for hereditary breast and ovarian cancer for both themselves and others. However, among the women who felt favorable about its usage, the majority said it became a new option for them to pursue parenthood whereas previously they had opted to not have a biological child. The high percentage of respondents who have never heard of preimplantation genetic diagnosis and who were in favor of this technology for hereditary breast and ovarian cancer indicates the need for educational campaigns to increase awareness and provide information about the procedure, access and affordability. Further research is needed to determine how this population would like this information presented to them and how best to instruct health care professionals to present this topic to women who do not know to ask about it. Keywords Breast cancer 1 and 2 genes Á Hereditary breast and ovarian cancer Á Preimplantation genetic diagnosis Á Qualitative research Abbreviations BRCA1/2 Breast cancer 1 and 2 genes HBOC Hereditary breast and ovarian cancer PGD Preimplantation genetic diagnosis IVF In vitro fertilization CVS Chorionic villous sampling FISH Fluorescence in situ hybridization FAPC Familial adenomatous polyposis coli HFEA Human fertilization and embryology authority FORCE Facing our risk of cancer empowered Introduction The majority of hereditary breast cancers are associated with mutations in BRCA1 and BRCA2 (BRCA1/2) tumor suppressor genes [1, 2]. Women who carry a BRCA1/2 mutation face up to an 80% lifetime risk of developing breast cancer and up to a 40% lifetime risk of developing ovarian cancer. This risk far exceeds the risks in the gen- eral population (13% for breast cancer and 1.5% for ovarian cancer) [3–8] and the age of diagnosis for carriers of this predisposing gene mutation is about 10–20 years earlier than for sporadic breast cancer [3]. These genes G. P. Quinn (&) Á S. T. Vadaparampil Á L. M. King Á C. A. Miree Á S. Friedman H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL 33612, USA e-mail: Gwen.Quinn@moffitt.org G. P. Quinn Á S. T. Vadaparampil College of Medicine, Department of Oncologic Science, University of South Florida, Tampa, FL, USA S. Friedman Facing Our Risk of Cancer Empowered (FORCE), Tampa, FL, USA 123 Familial Cancer (2009) 8:441–449 DOI 10.1007/s10689-009-9263-7