title: Do women change their breast cancer mammogram screening behaviour after BRCA1/2 testing?
abstract: Little is known about the change in mammograms use by women after BRCA1/2 genetic testing. We compared the rate of bilateral mammograms after and prior to BRCA1/2 testing, according to test result. Information from the Quebec Health Insurance Board database was used to identify all registered mammograms delivered between May 1, 1998 and March 31, 2012 to a cohort of 396 unaffected French Canadian women tested for BRCA1/2 mutations. Mammograms incidence density ratios were calculated using the Cox proportional hazards model for repeated events. BRCA1/2 mutation carriers and women with an inconclusive result had more mammograms after, than prior to, genetic testing. Non-carriers did not receive more mammograms. The observed increase in mammography screening in BRCA1/2 carriers is consistent with the high risk of developing breast cancer in this group. The estimation of the cancer risk associated with an inconclusive result is based on familial cancer history, and women who received this result appear to have received follow-up as if at high risk. The fact that non-carriers did not change their use of mammograms after genetic testing may possibly reflect a 'defensive medicine' approach by some physicians or the women's preference.
authors.affiliation: Faculté de Pharmacie, Université Laval, Quebec, QC, Canada.|Centre de Recherche du CHU de Québec - Université Laval, Quebec, QC, Canada.|Centre de Recherche sur le Cancer de l'Université Laval, Quebec, QC, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Larouche
authors.affiliation: Centre de Recherche du CHU de Québec - Université Laval, Quebec, QC, Canada.|Centre de Recherche sur le Cancer de l'Université Laval, Quebec, QC, Canada.|Centre des Maladies du sein Deschênes-Fabia, CHU de Québec - Université Laval, Quebec, QC, Canada.|Faculté de Médecine, Université Laval, Quebec, QC, Canada.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Chiquette
authors.affiliation: Centre de Recherche du CHU de Québec - Université Laval, Quebec, QC, Canada.|Centre de Recherche sur le Cancer de l'Université Laval, Quebec, QC, Canada.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Pelletier
authors.affiliation: Centre de Recherche du CHU de Québec - Université Laval, Quebec, QC, Canada.|Centre de Recherche sur le Cancer de l'Université Laval, Quebec, QC, Canada.|Faculté de Médecine, Université Laval, Quebec, QC, Canada.|Chaire de Recherche du Canada en Oncogénétique, Université Laval, Quebec, QC, Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Simard
authors.affiliation: Faculté de Pharmacie, Université Laval, Quebec, QC, Canada. Michel.Dorval@crchudequebec.ulaval.ca.|Centre de Recherche du CHU de Québec - Université Laval, Quebec, QC, Canada. Michel.Dorval@crchudequebec.ulaval.ca.|Centre de Recherche sur le Cancer de l'Université Laval, Quebec, QC, Canada. Michel.Dorval@crchudequebec.ulaval.ca.|Centre des Maladies du sein Deschênes-Fabia, CHU de Québec - Université Laval, Quebec, QC, Canada. Michel.Dorval@crchudequebec.ulaval.ca.
authors.forename: Michel
authors.initials: M
authors.lastname: Dorval
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D007722:Health Knowledge, Attitudes, Practice; D006579:Heterozygote; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D009154:Mutation; D011792:Quebec
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: Breast cancer genetic testing; Breast cancer screening; Genes BRCA 1; Genes BRCA 2; Mammography