BRCA1/2 mutation testing in breast cancer patients: a prospective study of the long-term psychological impact of approach during adjuvant radiotherapy.
This study assessed psychological distress during the first year after diagnosis in breast cancer patients approached for genetic counseling at the start of adjuvant radiotherapy and identified those vulnerable to long-term high distress. Of the approached patients some chose to receive a DNA test result (n = 58), some were approached but did not fulfill criteria for referral (n = 118) and some declined counseling and/or testing (n = 44). The comparative group consisted of patients not eligible for genetic counseling (n = 182) and was therefore not approached. Patients actively approached for genetic counseling showed no more long-term distress than patients not eligible for such counseling. There were no differences between the subgroups of approached patients. Predictors for long-term high distress or an increase in distress over time were pre-existing high distress and a low quality of life, having children, and having no family members with breast cancer. It is concluded that breast cancer patients can be systematically screened and approached for genetic counseling during adjuvant radiotherapy without imposing extra psychological burden. Patients vulnerable to long-term high distress already displayed high distress shortly after diagnosis with no influence of their medical treatment on their level of distress at long-term.
Department of Medical Oncology, University Medical Centre Utrecht, P.O. Box 85060, Utrecht, 3508 AB, The Netherlands. K.J.Schlich@umcutrecht.nl
Kathryn J
KJ
Schlich-Bakker
Margreet G E M
MG
Ausems
Maria
M
Schipper
Herman F J
HF
Ten Kroode
Carla C
CC
Wárlám-Rodenhuis
Jan
J
van den Bout
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology* / Q000532:radiotherapy; D003863:Depression / Q000209:etiology; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D011446:Prospective Studies; D013315:Stress, Psychological / Q000209:etiology*