Beating the Biological Clock: The Compressed Family Life Cycle of Young Women with BRCA Gene Alterations

ABSTRACT

Empirical and clinical literature suggests a temporal thread running through family narratives of hereditary disease, linking past experiences to current beliefs about risk. This study asked young women with elevated risk of developing hereditary breast or ovarian cancer (HBOC) how their family histories with cancer and their gene status inform meaning construction around cancer risk and family development. Twenty-three women aged 22–35 who carry a BRCA gene alteration completed illness genograms and open-ended, narrative interviews. Transcripts were analyzed using the Listening Guide, a narrative tool that emphasizes key themes, meanings, and relational structures. Data analysis revealed distinct priorities for (1) single versus partnered women and (2) women who wished to have children versus those who had completed childbearing or were not intending to have children. Findings suggest single women experience increased urgency at finding a life partner capable of handling the emotional strain of the cancer world and open to pursuing multiple paths toward parenthood. Further, participants' family experiences shaped beliefs about perceived time to achieve desired family goals, specifically having biological children, before a cancer diagnosis or the need for preventive surgery. Clinical practice and research implications are discussed.

KEYWORDS:

• Genetics
• human development
• family
• life course
• breast cancer
• beliefs
• couples
• family planning

I thank Sarah Gehlert, PhD, chair, Gina Miranda Samuels, PhD, and John Rolland, MD, for their mentorship. I also thank Daniel Gardner, PhD, and Ellen Tuchman, PhD, colleagues at the Silver School of Social Work, for reading prepared drafts and providing structured critiques. Thank you also to Yumi Nam for her energy and attention to detail.