Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer.
OBJECTIVE
Understanding how young girls respond to growing up with breast cancer family histories is critical given expansion of genetic testing and breast cancer messaging. We examined the impact of breast cancer family history on psychosocial adjustment and health behaviors among >800 girls in the multicenter LEGACY Girls Study.


METHODS
Girls aged 6 to 13 years with a family history of breast cancer or familial BRCA1/2 mutation (BCFH+), peers without a family history (BCFH-), and their biological mothers completed assessments of psychosocial adjustment (maternal report for 6- to 13-year-olds, self-report for 10- to 13-year-olds), breast cancer-specific distress, perceived risk of breast cancer, and health behaviors (10- to 13-year-olds).


RESULTS
BCFH+ girls had better general psychosocial adjustment than BCFH- peers by maternal report. Psychosocial adjustment and health behaviors did not differ significantly by self-report among 10- to 13-year-old girls. BCFH+ girls reported higher breast cancer-specific distress (P = .001) and were more likely to report themselves at increased breast cancer risk than BCFH- peers (38.4% vs 13.7%, P < .001), although many girls were unsure of their risk. In multivariable analyses, higher daughter anxiety was associated with higher maternal anxiety and poorer family communication. Higher daughter breast cancer-specific distress was associated with higher maternal breast cancer-specific distress.


CONCLUSIONS
Although growing up in a family at risk for breast cancer does not negatively affect general psychosocial adjustment among preadolescent girls, those from breast cancer risk families experience greater breast cancer-specific distress. Interventions to address daughter and mother breast cancer concerns and responses to genetic or familial risk might improve psychosocial outcomes of teen daughters.
Division of Hematology/Oncology, Department of Medicine, and Department of Medical Ethics and Health Policy, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; angela.bradbury@uphs.upenn.edu.
Angela R
AR
Bradbury
Division of Hematology-Oncology, Department of Medicine, and the Center for Clinical Cancer Genetics and Global Health, The University of Chicago, Chicago, Illinois;
Linda
L
Patrick-Miller
Department of Pediatrics, Division of Oncology, The Children's Hospital of Philadelphia and Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania;
Lisa
L
Schwartz
Biostatistics and Bioinformatics Facility, and.
Brian
B
Egleston
Division of Hematology/Oncology, Department of Medicine, and.
Colleen Burke
CB
Sands
Departments of Pediatrics and Medicine.
Wendy K
WK
Chung
Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada;
Gord
G
Glendon
Mailman School of Public Health, Columbia University Medical Center, New York, New York;
Jasmine A
JA
McDonald
Department of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, Massachusetts;
Cynthia
C
Moore
Department of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, Massachusetts;
Paula
P
Rauch
Department of Adolescent Medicine, Children's National Medical Center, Washington, District of Columbia;
Lisa
L
Tuchman
Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada; Departments of Molecular Genetics and Laboratory Medicine, and.
Irene L
IL
Andrulis
Department of Medicine, Division of Oncology, The University of Utah Health Sciences Center, Salt Lake City, Utah;
Saundra S
SS
Buys
College of Social Work, The University of Utah, Salt Lake City, Utah;
Caren J
CJ
Frost
Cancer Prevention Institute of California, Fremont, California; and Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, and Stanford Cancer Institute, Stanford, California.
Theresa H M
TH
Keegan
Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada; Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada;
Julia A
JA
Knight
Mailman School of Public Health, Columbia University Medical Center, New York, New York; Herbert Irving Comprehensive Cancer Center, and.
Mary Beth
MB
Terry
Cancer Prevention Institute of California, Fremont, California; and Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, and Stanford Cancer Institute, Stanford, California.
Esther M
EM
John
Department of Clinical Genetics, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania;
Mary B
MB
Daly
D000223:Adaptation, Psychological; D000293:Adolescent; D001943:Breast Neoplasms; D002648:Child; D005260:Female; D015438:Health Behavior; D006801:Humans; D000297:Psychology, Adolescent; D002666:Psychology, Child