title: Attitude towards prophylactic surgery and effects of genetic counselling in families with BRCA mutations. Austrian Hereditary Breast and Ovarian Cancer Group.
abstract: The intent of this study was to evaluate the effect that an awareness of being a BRCA1 or BRCA2 mutation carrier has on the attitude towards prophylactic surgery and on developing depression symptoms. Thirty-five families were selected on the basis of previously detected BRCA1 or 2 mutations and 90 family members were given the appropriate questionnaires. Prophylactic mastectomy (PM) was considered by 21% of the Austrian mutation carriers (29% affected and 8% non-affected carriers). The majority of affected and non-affected carriers expected PM to impair the quality of their life. Fifty per cent would undergo prophylactic oophorectomy (53% affected and 46% non-affected carriers). The self-rating depression scale indicated that following mutation result disclosure the depression scores of carriers decreased (40 baseline vs 38 after result disclosure, P = 0.3), whereas, for non-carriers, scores increased (36 baseline vs 40 after result disclosure, P = 0.05). We conclude that information about carrier status is not associated with increased depression symptoms in mutation carriers. In non-carriers, depression scores increased slightly, probably reflecting survivor guilt. The option of having PM was associated with a negative impact on the quality of life and was declined by the majority of Austrian mutation carriers.
authors.affiliation: Department of Obstetrics and Gynaecology, General Hospital, University of Vienna, Austria.
authors.forename: T M
authors.initials: TM
authors.lastname: Wagner
authors.forename: R
authors.initials: R
authors.lastname: Möslinger
authors.forename: G
authors.initials: G
authors.lastname: Langbauer
authors.forename: R
authors.initials: R
authors.lastname: Ahner
authors.forename: E
authors.initials: E
authors.lastname: Fleischmann
authors.forename: A
authors.initials: A
authors.lastname: Auterith
authors.forename: A
authors.initials: A
authors.lastname: Friedmann
authors.forename: T
authors.initials: T
authors.lastname: Helbich
authors.forename: C
authors.initials: C
authors.lastname: Zielinski
authors.forename: E
authors.initials: E
authors.lastname: Pittermann
authors.forename: M
authors.initials: M
authors.lastname: Seifert
authors.forename: P
authors.initials: P
authors.lastname: Oefner
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000235:genetics* / Q000517:prevention & control; D003863:Depression; D005260:Female; D019398:Genes, BRCA1 / Q000235:genetics*; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control; D010052:Ovariectomy / Q000523:psychology; D010375:Pedigree; D011788:Quality of Life