The primary purpose of this study is to evaluate the effect of systematic identification and genetic counseling referral on rates of bilateral salpingo-oophorectomy (surgery to remove both fallopian tubes and ovaries) in women having mammograms at Swedish Medical Center in Seattle, WA.

Inclusion Criteria:

• Prior mammogram at Swedish Medical Center
• Willing and able to provide informed consent, primary physician information, and complete study questionnaires
• Must meet at least ONE of the following criteria:
• personal history of breast cancer diagnosed before age 50
• personal history of bilateral breast cancer at any age
• 1 or more first degree relatives with breast cancer diagnosed before age 50
• 3 or more first or second degree relatives with breast cancer at any age
• 2 second degree relatives with breast cancer diagnosed before age 50
• A male relative with breast cancer at any age
• Ashkenazi Jewish with any family history of breast or ovarian cancer
• 1 first or second degree relative with ovarian cancer AND 1 first or second degree relative with breast cancer at any age
• 2 first degree relatives with ovarian cancer or 2 second degree relatives with ovarian cancer or 1 first and 1 second degree relative with ovarian cancer.
• A first degree relative with both breast and ovarian cancer (2 primaries in the same person)
• Personal history of positive genetic test result for any of the following genes: BRCA1, BRCA2, HNPCC, or P53
• Family history of a positive genetic test result for any of the following genes: BRCA1, BRCA2 or HNPCC

Exclusion Criteria:

• Previous diagnosis of ovarian cancer
• Prior bilateral-salpingo oophorectomy
• Had a negative genetic test result for a known family genetic mutation