title: BRCA1/2 test results impact risk management attitudes, intentions, and uptake.
abstract: Women who receive positive or uninformative BRCA1/2 test results face a number of decisions about how to manage their cancer risk. The purpose of this study was to prospectively examine the effect of receiving a positive versus uninformative BRCA1/2 genetic test result on the perceived pros and cons of risk-reducing mastectomy (RRM) and risk-reducing oophorectomy (RRO) and breast cancer screening. We further examined how perceived pros and cons of surgery predict intention for and uptake of surgery. 308 women (146 positive, 162 uninformative) were included in RRM and breast cancer screening analyses. 276 women were included in RRO analyses. Participants completed questionnaires at pre-disclosure baseline and 1-, 6-, and 12-months post-disclosure. We used linear multiple regression to assess whether test result contributed to change in pros and cons and logistic regression to predict intentions and surgery uptake. Receipt of a positive BRCA1/2 test result predicted stronger pros for RRM and RRO (P < 0.001), but not perceived cons of RRM and RRO. Pros of surgery predicted RRM and RRO intentions in carriers and RRO intentions in uninformatives. Cons predicted RRM intentions in carriers. Pros and cons predicted carriers' RRO uptake in the year after testing (P < 0.001). Receipt of BRCA1/2 mutation test results impacts how carriers see the positive aspects of RRO and RRM and their surgical intentions. Both the positive and negative aspects predict uptake of surgery.
authors.affiliation: Cancer Control Program and Fisher Center for Familial Cancer Research, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA. sco4@georgetown.edu
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: O'Neill
authors.forename: Heiddis B
authors.initials: HB
authors.lastname: Valdimarsdottir
authors.forename: Tiffani A
authors.initials: TA
authors.lastname: Demarco
authors.forename: Beth N
authors.initials: BN
authors.lastname: Peshkin
authors.forename: Kristi D
authors.initials: KD
authors.lastname: Graves
authors.forename: Karen
authors.initials: K
authors.lastname: Brown
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hurley
authors.forename: Claudine
authors.initials: C
authors.lastname: Isaacs
authors.forename: Sharon
authors.initials: S
authors.lastname: Hecker
authors.forename: Marc D
authors.initials: MD
authors.lastname: Schwartz
mesh_terms: D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology / Q000628:therapy; D002755:Choice Behavior; D004252:DNA Mutational Analysis / Q000523:psychology; D005260:Female; D005820:Genetic Testing / Q000379:methods / Q000523:psychology*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D016014:Linear Models; D016015:Logistic Models; D008403:Mass Screening / Q000523:psychology; D008408:Mastectomy / Q000523:psychology; D008875:Middle Aged; D009154:Mutation; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology / Q000628:therapy; D010052:Ovariectomy / Q000523:psychology; D010342:Patient Acceptance of Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
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