Journal of Experimental & Clinical Cancer Research 2008, 27:75 http://www.jeccr.com/content/27/1/75 Background The possibility of taking advantage of genetic counselling for familial/hereditary breast/ovarian cancer enables a woman, with a family history of cancer, to understand their risk of developing the disease during their life time and undertake adequate provision to manage the risk through a programme of clinical observation or eventual precautionary surgery. Furthermore, the possibility of being made aware of one's risk, also enables the counse- lees to protect their family and in particular their children, involving them in the process of genetic counselling and prevention programs. A number of studies have reported that counselees claim a great interest in undergoing the genetic test[1-3]; but it is a fact that, in the same studies the number of subjects who actually underwent the genetic test, even if they com- plied with the eligibility criteria, is decidedly low [4]. The literature concerning the psychological side of onco- genetic counselling often focuses on the variables which influence the decision to undergo the test and show some basic variables such as; estimated cancer risk [2,5], expected benefit or limitations of genetic testing, [6-8], general psychological distress or cancer-specific distress [7,9], lack of trust in one's emotional reactions when faced with negative events[10], expected level of family support and communications within the family[11-13]. The present study aims at describing some psychosocial variables in an Italian group of patients who interrupted the process of genetic counselling for hereditary/familial breast/ovarian cancer, following an initial informative session. Furthermore, it aims at evaluating motivations, reported by the subjects themselves, which have led to their decision to discontinue the process of counselling and probable association between motivation and psy- chosocial variables. Methods From May 2002 to December 2006, 380 subjects requested a first appointment for genetic counselling at the Department for Hereditary Tumours of the Breast and/ or Ovaries of "Regina Elena" National Cancer Institute of Rome. An informative pre-counselling session by the pri- mary care physician is not envisaged, the subjects freely telephone the out-patient office to learn one's risk of developing a breast and/or ovarian tumour. During the initial informative genetic session the oncologist, sup- ported by a psychologist, supplies the patient information concerning BRCA1 and BRCA2 mutation genes which pre- disposes one to breast/ovarian tumours, concerning the method of transmission, the possibility of prevention and treatment of hereditary pathologies. The physician offers the counselee to initiate the next appointment in which a family history will be obtained and eligibility for genetic testing will be determined. Of these 380 subjects who received the first counselling informative session, 106 never asked for a second coun- selling session to have the family tree drawn up in order to inquire about their eligibility for genetic testing, 28% of the sample. These 106 subjects were contacted by telephone by a psy- chologist, in order to request participation in the study. Once permission from patients was obtained, some ques- tionnaires were sent out to be filled in by the counselee and returned in the enclosed stamped envelope provided. This was to be done within 20 days following the first con- tact, failing which, a second telephone call was made, requesting the return of the questionnaire. The subject was dropped from the study if their questionnaire was not received in forty days. All the procedure was discussed and approved by local Ethic Committee. Study Population From December 2006 to March 2007, 106 subjects, 3 men and 103 women, were contacted. Six subjects refused to take part in the study, 35 did not return the questionnaire, and 9 sent them back incomplete. The study was then car- ried out on a sample of 56 subjects, 2 men and 54 women, affected by breast and/or ovarian cancer, or healthy but with a family history of cancer (at least one affected rela- tive). 53% took part in the study. Instruments Form for the socio-demographic and medical characteristics The test variables were; age, gender, place of birth, civil status, number of children, education, employment, reli- gion or whether they are practicing, cancer, number of rel- atives affected by cancer. Cancer Risk Perception (CRP) One item taken from prior research [14,15], was to evalu- ate the possible risk of the subject developing cancer. " Mark with a cross on a scale of 0 to 100 what you consider to be your risk of developing, or re-developing, breast and ovarian cancer". Reply was given on a Visual analogue scale of 0 to 100%: 0 representing the lowest risk, 100 the highest and a blank space "do not know". Genetic Risk Perception (GRP) Another item taken from prior research[16], was to evalu- ate the likelihood to be a carrier of the BRCA1/BRCA2 genetic mutation. " Mark with a cross on a scale of 0 to 100 what you consider to be your risk of being a carrier of the genetic mutation predisposing one to breast and ovar- ian cancer". Reply was given on a Visual Analogue Scale Page 2 of 8 (page number not for citation purposes)