Primary care physicians may have to authorize consultations in order for insurance to cover fees. The patient's first visit follows. Ideally, the patient will have his or her medical records sent before this visit. The counselor and the patient undertake a systematic review of family members with cancer, as well as those without cancer. One of the central goals of genetic counseling is to develop surveillance and prevention strategies based on the patient's risk of cancer.
Prevention is discussed at the first meeting and is revisited during any subsequent appointments.
Lifestyle factors are covered, as are their limitations. The patient and clinicians also discuss screening methods, such as mammography or colonoscopy, and their potential benefits and limitations. Prophylactic surgery is discussed in depth, helping the patient to understand the potential benefits and risks involved. Newer chemoprevention options, such as tamoxifen and raloxifene for breast cancer, are explored. The opportunity for referral to surgeons, plastic surgeons, and other specialists is reviewed and coordinated with referring physicians at this time.