乳腺癌基因检测与健康沟通实践及其所处的广泛社会背景密切相关。语言学方法可以从女性自费进行BRCA1/2基因检测的角度，对她们在谈话中所表达的经历、知识、角色、选择和情感进行视角分析。在语言学方法论中，我们采用了一种话语建构主义认识论和叙事理论的框架。对自费基因检测的低至中度BRCA1/2致病变异风险的妇女进行了八个电话访谈的语音记录，进行了“小故事”和立场采取的分析。我们发现，“小故事”非常普遍，包括事件描述、假设、习惯性叙述以及结合多种类型的故事。立场采取是参与者在谈话背景下塑造个人身份，比如负责任的角色。通过立场采取策略，参与者还积极协商谈话议程，例如对面试者对情感的态度表达不同程度的一致性。本研究为了解与乳腺癌基因检测相关的遗传咨询交流中的语言标记提供了基础。增强对客户语言选择、小故事和立场的认识，以及这些对客户对经历和选择的评估、与遗传咨询师问题/陈述的一致性，以及对谈话的投入程度的意义，有可能提高治疗交流的效果。 转载：©2023 Wiley Periodicals LLC代表国家遗传咨询师协会出版的《遗传咨询杂志》 版权所有。

Genetic testing for breast cancer genes is an experience which is inextricably linked with health communication practices and the broader social context in which it occurs. Linguistic approaches can provide perspective on how women seeking self-funded BRCA1/2 gene testing represent their experiences, knowledge, roles, choices and emotions through the way they talk. A discursive constructionist epistemology and narrative theoretical framework informed the applied linguistics methodology. Analysis of 'small stories' and stance-taking was performed on eight transcripts of audio-recorded telephone interviews with women at low to moderate risk of carrying BRCA1/2 pathogenic variants who self-funded genetic testing. We found a high prevalence of 'small stories' including accounts of events, hypotheticals, habitual narratives, and stories which combined multiple genres. Stance-taking was a means by which participants constructed personal identities in the conversational context, such as that of a responsible person. Via stance-taking strategies, participants also actively negotiated the conversational agenda, for example expressing different degrees of alignment with the interviewer's orientation towards emotions. This study provides a basis for recognizing linguistic markers in genetic counseling interactions about genetic testing for breast cancer genes. Enhanced awareness of client language choice, and the ways in which small stories and stance can signify the client's evaluation of experience and choices, alignment with the genetic counselor's questions/statements, and investment in the conversation, has potential to improve the therapeutic interaction.© 2023 The Authors. Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.