title: Psychological distress and quality of life associated with genetic testing for breast cancer risk.
abstract: This study investigated short- and long-term psychological outcomes associated with BRCA1/2 genetic testing in women with a personal or family history of breast cancer. Participants included 126 women considering genetic testing. Questionnaires were administered prior to testing, one week, three and six months after result disclosure. Results indicated no systematic effects of testing based on personal cancer history. Mutation carriers and women who elected not to be tested reported greater perceived risk and intrusive and avoidant thoughts at follow-up time points than did women who received negative (uninformative) or variant results. Mutation carriers reported more distress at the three-month follow-up but by six months the effects of test result on distress dissipated and groups were comparable. Cluster analyses identified two groups of individuals based on distress at baseline; these groups were used to predict psychological outcomes after testing. Distress remained constant in both groups: those who were high at baseline remained high and those who were low remained low. Test results did not moderate this effect. Results suggest that genetic testing for BRCA1/2 does not increase distress or have deleterious effects on quality of life over the long term. However, sub-groups of women may report more distress over time. These data indicate the need for more targeted counseling to individuals who report high levels of distress when considering genetic testing.
authors.affiliation: Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA. smithas@mail.nih.gov
authors.forename: Ashley Wilder
authors.initials: AW
authors.lastname: Smith
authors.forename: Angela Liegey
authors.initials: AL
authors.lastname: Dougall
authors.forename: Donna M
authors.initials: DM
authors.lastname: Posluszny
authors.forename: Tamara J
authors.initials: TJ
authors.lastname: Somers
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Rubinstein
authors.forename: Andrew
authors.initials: A
authors.lastname: Baum
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005820:Genetic Testing / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D017354:Point Mutation; D011788:Quality of Life / Q000523:psychology*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult