Women worried about their familial breast cancer risk--a study on genetic advice in general practice.
OBJECTIVE
To ascertain whether women who consulted their GP because they perceived themselves as at increased risk of familial breast cancer were indeed at increased risk, and to evaluate potential strategies for assessing genetic risk of breast cancer in general practice.


METHODS
Sixty-seven out of 81 women who had consulted their GP for advice about their possible increased risk of developing breast cancer due to breast cancer in the family were interviewed. Familial breast cancer risk was assessed by a clinical geneticist. This assessment was compared with two recent guidelines for referral for genetic counselling.


RESULTS
More than half (52%; n = 35) the women had a relative risk of two and over for developing breast cancer, while another half of these 35 (25%; n = 17) had a relative risk of three and over. All the women (n = 17) with a relative risk of three and over were identified by means of the two current guidelines for referral for genetic counselling, while more than half of the women (61%; n = 11) with a relative risk between two and three were identified.


CONCLUSIONS
More than half the women concerned about their familial risk of breast cancer are indeed at increased risk of breast cancer. Current guidelines correctly identify women at high risk. However, doubts about the health gain and feasibility of referral warrant caution, and need further investigation.
de Bock
G H
GH
Department of General Practice, University of Leiden, The Netherlands.
Perk
D C
DC
Oosterwijk
J C
JC
Hageman
G C
GC
Kievit
J
J
Springer
M P
MP
D000328:Adult; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000235:genetics* / Q000523:psychology*; D005192:Family Health; D005194:Family Practice; D005260:Female; D005817:Genetic Counseling / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D010375:Pedigree; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000592:standards*; D018570:Risk Assessment