The quality of life associated with prophylactic treatments for women with BRCA1/2 mutations.
OBJECTIVE
This study was conducted to obtain and compare the preferences assigned to cancer states and prevention measures by women who had breast cancer, were at high risk for breast cancer, or had neither condition.


METHODS
We administered a time trade-off questionnaire to 21 breast cancer patients, 28 women with a personal history of multiple breast biopsies or a family history of breast cancer, and 135 women without these conditions (the reference group). We stratified the reference group into two groups aged 20 to 32 years and 33 to 50 years, respectively.


RESULTS
All four groups assigned higher preference to breast cancer than to ovarian cancer. Both reference groups preferred using a tamoxifen-like drug to having mastectomy or oophorectomy for cancer prevention; the high-risk and breast cancer groups did not. None of the four groups had a preference between prophylactic mastectomy and breast cancer. All the groups were willing to subtract more years from their life expectancy to protect offspring from genetic risk than to protect themselves. Reference group members in the 33- to 50-year age range had lower mean ratings than the breast cancer group for almost all the health states, and breast cancer patients were less willing than other respondents to trade time for health. Most of these differences were not statistically significant. The high-risk group was similar to the older reference group in time trade-off ratings.


CONCLUSIONS
The time trade-off-based preferences of healthy women may be used to predict the treatment preferences of women with BRCA1/2 mutations. Obtaining healthy women's ratings of treatment outcomes may help health care policy makers envision the consequences of the difficult choices that high-risk women face.
Grann
V R
VR
Herbert Irving Comprehensive Cancer Center, New York, New York, USA.
Jacobson
J S
JS
Sundararajan
V
V
Albert
S M
SM
Troxel
A B
AB
Neugut
A I
AI
D000328:Adult; D024682:BRCA2 Protein; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control*; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005192:Family Health; D005260:Female; D019398:Genes, BRCA1 / Q000235:genetics*; D006579:Heterozygote; D006801:Humans; D008017:Life Expectancy; D008875:Middle Aged; D009154:Mutation; D009363:Neoplasm Proteins / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control; D011322:Primary Prevention; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014157:Transcription Factors / Q000235:genetics*
D024682:BRCA2 Protein; D009363:Neoplasm Proteins; D014157:Transcription Factors