title: Concerns about inherited risk of breast cancer prior to diagnosis in Japanese patients with breast complaints.
abstract: The purpose of this study was to reveal characteristics that underlie patients' expressions of concern about their genetic risk of breast cancer at an initial outpatient clinic visit prior to a definitive diagnosis of cancer. A total of 233 women, at their initial outpatient clinic visits, participated in semi-structured and open-ended interviews that surveyed their anxieties, worries, thoughts, and feelings. Each patient completed a self-administered survey comprising questions about her family history of breast cancer and responded to a questionnaire that assessed psychological distress. Patients were divided into those who expressed concerns about inherited risk of breast cancer during the interview (expression group, n = 39) and those who did not (non-expression group, n = 194). Although patients in the expression group tended to have higher rates of breast cancer in their families, patients without a family history of breast cancer also expressed concerns. We used qualitative content analysis to identify the emotions and thoughts of patients expressing these concerns. Patients with a family history of breast cancer experienced anxiety/worry, risk-reducing behavior, acceptance, objective fact, and denial, whereas patients without a family history of breast cancer experienced anxiety/worry, risk-reducing behavior, surprise/shock, acceptance, objective fact, denial, optimistic thought, regret, and realistic thought. Some patients in the breast clinic had concerns about their inherited risk of cancer, despite lacking a family history of breast cancer. Health care professionals should inquire about family histories and provide appropriate support and counseling to patients as needed, regardless of the patient's genetic risk for the disease.
authors.affiliation: Department of Medical Psychology, Pharmaceutical Education Research Center, Kitasato University School of Pharmacy, Minato, Tokyo, Japan. andon@pharm.kitasato-u.ac.jp
authors.forename: Noriko
authors.initials: N
authors.lastname: Ando
authors.forename: Yumi
authors.initials: Y
authors.lastname: Iwamitsu
authors.forename: Masaru
authors.initials: M
authors.lastname: Kuranami
authors.forename: Shigemi
authors.initials: S
authors.lastname: Okazaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyaoka
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D007564:Japan; D008875:Middle Aged; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires