Cancer risk management practices of noncarriers within BRCA1/2 mutation positive families in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer.
OBJECTIVE
Women from BRCA mutation-positive families who do not carry the family-specific mutation are generally at average cancer risk and therefore do not require intensive risk management.


METHODS
Participants were female noncarriers from BRCA mutation-positive families who had responded to 3 yearly follow-up questionnaires and had chosen to either receive or not receive their genetic test result. In the former group, undertaking mammography younger than age 40 years or more than once every 2 years, clinical breast examination (CBE) more than yearly, breast self-examination (BSE) more than monthly, or any transvaginal ultrasound (TVU) or CA-125 was considered overscreening. Screening behaviors of women who did and did not know their genetic test result were compared. Logistic regression and nonparametric analyses were performed to identify demographic and psychosocial factors (respectively) associated with overscreening.


RESULTS
Of 325 eligible women, 116 knew their mutation status and 209 did not. For the first group, proportions overscreening were mammography, 53%; CBE, 10%; BSE, 11%; TVU, 7%; and CA-125, 10%. There were no significant differences in screening behaviors between the groups. In those aware of their mutation status, parous women were more likely to overuse mammography (odds ratio [OR] = 4.4; 95% CI, 1.1 to 17; P = .03) and women with one or more first-degree relative with ovarian cancer (OC) were more likely to overuse OC screening (TVU: OR = 6.00; 95% CI, 1.0 to 35.1; P = .047, and CA-125: OR = 6.50; 95% CI, 1.49 to 28.4; P = .013).


CONCLUSIONS
The reasons for overuse of screening (particularly mammography) by mutation noncarriers require additional elucidation given the potential for harm.
Dawson
Sarah-Jane
SJ
Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Locked Bag No. 1, A'Beckett St, Victoria, 8006, Australia.
Price
Melanie A
MA
Jenkins
Mark A
MA
McKinley
Joanne M
JM
Butow
Phyllis N
PN
McLachlan
Sue-Anne
SA
Lindeman
Geoffrey J
GJ
Weideman
Prue
P
Friedlander
Michael L
ML
Hopper
John L
JL
Phillips
Kelly-Anne
KA
D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D016504:Breast Self-Examination; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D009154:Mutation; D012307:Risk Factors; D012308:Risk Management / Q000379:methods*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D019564:Unnecessary Procedures