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

IF 2 4区医学 Q3 ONCOLOGY

Hereditary Cancer in Clinical Practice Pub Date : 2022-12-19 DOI:10.1186/s13053-022-00244-y

Julia Dick, Anja Tüchler, Anne Brédart, Frank Vitinius, Kirsten Wassermann, Kerstin Rhiem, Rita K Schmutzler

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引用次数: 1

Abstract

Background: Women 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.

Methods: Breast 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.

Results: A 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.

Conclusions: Considering 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 registration: Retrospectively registered at the German Clinical Trials Register under DRKS00027566 on January 13, 2022.

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BRCA1/2致病变异携带者的心理因素和预防措施:一项前瞻性队列研究的结果

背景:携带BRCA1/2致病变异的女性患乳腺癌(BC)的风险升高，并且面临着一个复杂的预防措施决策过程，即降低风险的乳房切除术(RRM)和加强乳房监测(IBS)。在这项前瞻性队列研究中，我们调查了焦虑、人格因素和应对方式对BRCA1/2致病变异女性风险管理选择决策过程的影响。方法:对BRCA1或BRCA2基因致病性变异的未受影响和未受影响的乳腺癌患者在基因检测结果披露前(T0)、6 ~ 8周(T1)和6 ~ 8个月(T2)进行心理评估。在T2时评估RRM和IBS的摄取情况。心理数据采用风险感知、人格因素、应对方式、决策冲突、抑郁和焦虑问卷，包括医院焦虑和抑郁量表(HADS)。我们进行了统计显著性检验，并根据显著性水平拟合了逻辑回归。结果:共有98名女性被纳入分析。选择RRM的妇女的基线焦虑水平很高，但随着时间的推移而下降，而选择强化乳房监测(IBS)的妇女的基线焦虑水平则有所增加。基因检测结果披露(T1)后焦虑水平升高与接受RRM的决定相关(p)结论:考虑影响BRCA1/2致病变异女性决策过程的社会心理因素可能有助于改善其遗传和心理咨询。当选择肠易激综合症时，他们可能会从额外的医疗和心理咨询中获益。试验注册:于2022年1月13日根据DRKS00027566在德国临床试验注册中心回顾性注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hereditary Cancer in Clinical Practice 医学-肿瘤学

CiteScore

3.10

自引率

5.90%

发文量

审稿时长

>12 weeks

期刊介绍： Hereditary Cancer in Clinical Practice is an open access journal that publishes articles of interest for the cancer genetics community and serves as a discussion forum for the development appropriate healthcare strategies. Cancer genetics encompasses a wide variety of disciplines and knowledge in the field is rapidly growing, especially as the amount of information linking genetic differences to inherited cancer predispositions continues expanding. With the increased knowledge of genetic variability and how this relates to cancer risk there is a growing demand not only to disseminate this information into clinical practice but also to enable competent debate concerning how such information is managed and what it implies for patient care. Topics covered by the journal include but are not limited to: Original research articles on any aspect of inherited predispositions to cancer. Reviews of inherited cancer predispositions. Application of molecular and cytogenetic analysis to clinical decision making. Clinical aspects of the management of hereditary cancers. Genetic counselling issues associated with cancer genetics. The role of registries in improving health care of patients with an inherited predisposition to cancer.