Family Systems genetic Illness Model--breast cancer.

Mrs. R and others like her are having prophylactic surgery to prevent breast cancer based primarily on their family history, personal history, and environmental risks. Although the clinical application of genetics medical research is in its infancy, its relevance to breast cancer already is making significant I advances toward more accurate prognosis and treatment options for women and their families. Illness and death from breast cancer continue to limit human existence, whereas new information and medical treatments increase the complexity of healthcare decisions and family life. Rolland and Williams' (2005) FSGI Model helps nurses and advanced practice nurses understand how illnesses such as breast cancer likely will affect patients' lives and families, well before any biologic markers are detectable. Considering the complexity of medical information that currently is available and the risks involved in genetic testing for breast cancer, the best recommendation at this time for people with a family history of breast cancer is to see a genetics counselor. Nurses can help individuals and families prepare for counselors by giving them a list of helpful questions and recommending that they bring a trusted family member or confidant to the meeting. For women who decide to have prophylactic breast surgery, nurses play a significant role in helping them prepare for the emotional and physiologic ramifications. The FSGI Model anticipates the time when families will have an overall genetic risk profile, which can guide them in their prevention efforts and truly give them informed consent.