Psychological factors and the uptake of preventative measures in BRCA1/2 pathogenic variant carriers: results of a prospective cohort study

Hereditary Cancer in Clinical Practice

Research

Rita K. Schmutzler¹  Julia Dick¹  Anja Tüchler¹  Kerstin Rhiem¹  Frank Vitinius²  Anne Brédart³  Kirsten Wassermann⁴ 

[1] Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany;Department of Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Institut Curie, Supportive Care Department, Psycho-oncology Unit, 26 rue d’Ulm, 75005 Paris Cedex 05, Paris, France;Paris University, Psychology Institute, Psychopathology and health process laboratory UR4057, 71 avenue Edouard Vaillant, 92774, Boulogne-Billancourt, France;Psychologische Praxis, Bonn, Germany;

关键词: Risk reduction behavior;    Breast cancer, familial;    Anxiety;    Decision making;    Risk-reducing mastectomy;   

DOI  :  10.1186/s13053-022-00244-y

 received in 2022-01-18, accepted in 2022-11-23,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundWomen carrying BRCA1/2 pathogenic variants are exposed to elevated risks of developing breast cancer (BC) and are faced by a complex decision-making process on preventative measures, i.e., risk-reducing mastectomy (RRM), and intensified breast surveillance (IBS). In this prospective cohort study we investigated the effect of anxiety, personality factors and coping styles on the decision-making process on risk management options in women with pathogenic variants in BRCA1/2.MethodsBreast cancer unaffected and affected women with a pathogenic variant in the BRCA1 or BRCA2 gene were psychologically evaluated immediately before (T0), 6 to 8 weeks (T1) and 6 to 8 months (T2) after the disclosure of their genetic test results. Uptake of RRM and IBS was assessed at T2. Psychological data were gathered using questionnaires on risk perception, personality factors, coping styles, decisional conflict, depression and anxiety, including the Hospital Anxiety and Depression Scale (HADS). We performed tests on statistical significance and fitted a logistic regression based on significance level.ResultsA total of 98 women were included in the analysis. Baseline anxiety levels in women opting for RRM were high but decreased over time, while they increased in women opting for intensified breast surveillance (IBS). Elevated levels of anxiety after genetic test result disclosure (T1) were associated with the decision to undergo RRM (p < 0.01; OR = 1.2, 95% CI = 1.05–1.42), while personal BC history and personality factors seemed to be less relevant.ConclusionsConsidering psychosocial factors influencing the decision-making process of women with pathogenic variants in BRCA1/2 may help improving their genetic and psychological counselling. When opting for IBS they may profit from additional medical and psychological counselling.Trial registrationRetrospectively registered at the German Clinical Trials Register under DRKS00027566 on January 13, 2022.

【 授权许可】

CC BY   
© The Author(s) 2022

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