title: Breast cancer genetic counseling after diagnosis but before treatment: a pilot study on treatment consequences and psychological impact.
abstract: OBJECTIVE
  Female breast cancer patients carrying a BRCA1/2-mutation have an increased risk of second primary breast and ovarian tumors. Little is known about the psychological impact and treatment consequences of rapid genetic counseling and testing offered between breast cancer diagnosis and surgery.
  
  
  METHODS
  Female breast cancer patients, who had received rapid genetic counseling (and optional testing) (RGC(T)) at The Netherlands Cancer Institute between 2004 and 2008, received a questionnaire in 2009.
  
  
  RESULTS
  BRCA-mutations were found in 10 of the 26 participants. Six mutation-carriers (60%) had an immediate bilateral mastectomy, compared with 25% of those without a mutation. Five patients (19%) reported having frequent worries about cancer recurrence; none indicated that such worries impaired daily functioning. Six patients had clinically relevant levels of breast cancer-specific distress at the time of assessment.
  
  
  CONCLUSIONS
  These results suggest that RGC(T) in high-risk breast cancer patients may influence surgical treatment, without causing long-term psychosocial distress in the majority.
  
  
  CONCLUSIONS
  These results are important, since rapid genetic counseling and testing are expected to be offered to newly diagnosed breast cancer patients with increasing frequency in order to inform these women and their surgeons about the possible familial/hereditary nature of their disease before deciding on treatment.
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Marijke R
authors.initials: MR
authors.lastname: Wevers
authors.forename: Daniela E E
authors.initials: DE
authors.lastname: Hahn
authors.forename: Senno
authors.initials: S
authors.lastname: Verhoef
authors.forename: Marijke D K
authors.initials: MD
authors.lastname: Bolhaar
authors.forename: Margreet G E M
authors.initials: MG
authors.lastname: Ausems
authors.forename: Neil K
authors.initials: NK
authors.lastname: Aaronson
authors.forename: Eveline M A
authors.initials: EM
authors.lastname: Bleiker
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology* / Q000601:surgery; D003657:Decision Making; D005260:Female; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000379:methods* / Q000523:psychology; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000706:statistics & numerical data; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009426:Netherlands; D057240:Patient Preference; D017060:Patient Satisfaction; D010865:Pilot Projects; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult