title: Active approach for breast cancer genetic counseling during radiotherapy: long-term psychosocial and medical impact.
abstract: Genetic counseling and DNA testing (GCT) for breast cancer is increasingly being actively offered to newly diagnosed patients. Little is known about the consequences of such an approach. Therefore, the long-term psychosocial and medical impact of referring breast cancer patients for GCT during an early phase of treatment was studied. A group of 112 breast cancer patients who had been actively offered GCT during adjuvant radiotherapy 7-14 years earlier, returned a self-report questionnaire. We compared their experiences with a group of 127 breast cancer patients who had not met the criteria for GCT. In total, 239 women participated in this long-term follow-up study (72% response rate). Nearly 75% of them had received regular mammography surveillance in the past 3 years. Preventive surgery was reported more often in the counseling group (specifically in the BRCA1/2 mutation carriers). Like the comparative group, only a minority of patients who had received GCT were experiencing high levels of depression (5%) or psychological distress (14%). Breast cancer patients can be actively approached and referred for GCT at the beginning of their radiotherapy without a threat to psychological functioning in the long term.
authors.affiliation: Division of Biomedical Genetics, Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands; Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Baars
authors.forename: E M A
authors.initials: EM
authors.lastname: Bleiker
authors.forename: E
authors.initials: E
authors.lastname: van Riel
authors.forename: C C
authors.initials: CC
authors.lastname: Rodenhuis
authors.forename: M E
authors.initials: ME
authors.lastname: Velthuizen
authors.forename: K J
authors.initials: KJ
authors.lastname: Schlich
authors.forename: M G E M
authors.initials: MG
authors.lastname: Ausems
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D003863:Depression / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000523:psychology*; D005820:Genetic Testing; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: breast cancer; genetic counseling and DNA testing; hereditary breast and ovarian cancer syndrome; long-term effects; prophylactic mastectomy; psychological stress; surveillance