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BRCA1/2 test results impact risk management attitudes, intentions, and uptake

  • Epidemiology
  • Published:
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Abstract

Women who receive positive or uninformative BRCA1/2 test results face a number of decisions about how to manage their cancer risk. The purpose of this study was to prospectively examine the effect of receiving a positive versus uninformative BRCA1/2 genetic test result on the perceived pros and cons of risk-reducing mastectomy (RRM) and risk-reducing oophorectomy (RRO) and breast cancer screening. We further examined how perceived pros and cons of surgery predict intention for and uptake of surgery. 308 women (146 positive, 162 uninformative) were included in RRM and breast cancer screening analyses. 276 women were included in RRO analyses. Participants completed questionnaires at pre-disclosure baseline and 1-, 6-, and 12-months post-disclosure. We used linear multiple regression to assess whether test result contributed to change in pros and cons and logistic regression to predict intentions and surgery uptake. Receipt of a positive BRCA1/2 test result predicted stronger pros for RRM and RRO (P < 0.001), but not perceived cons of RRM and RRO. Pros of surgery predicted RRM and RRO intentions in carriers and RRO intentions in uninformatives. Cons predicted RRM intentions in carriers. Pros and cons predicted carriers’ RRO uptake in the year after testing (P < 0.001). Receipt of BRCA1/2 mutation test results impacts how carriers see the positive aspects of RRO and RRM and their surgical intentions. Both the positive and negative aspects predict uptake of surgery.

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Acknowledgments

Grant support: National Cancer Institute Grant RO1 CA01846 (MDS). The authors would like to thank Michael Green and Lisa Moss for their contributions to this research.

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Authors and Affiliations

  1. Cancer Control Program and Fisher Center for Familial Cancer Research, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA

    Suzanne C. O’Neill, Tiffani A. DeMarco, Beth N. Peshkin, Kristi D. Graves, Claudine Isaacs, Sharon Hecker & Marc D. Schwartz

  2. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA

    Heiddis B. Valdimarsdottir

  3. Department of Public Health and Education, University of Reykjavik, Reykjavik, Iceland

    Heiddis B. Valdimarsdottir

  4. Department of Psychology, University of Iceland, Reykjavik, Iceland

    Heiddis B. Valdimarsdottir

  5. Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, NY, USA

    Karen Brown

  6. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Karen E. Hurley

Authors
  1. Suzanne C. O’Neill
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  2. Heiddis B. Valdimarsdottir
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  3. Tiffani A. DeMarco
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  4. Beth N. Peshkin
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  5. Kristi D. Graves
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  6. Karen Brown
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  7. Karen E. Hurley
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  8. Claudine Isaacs
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  9. Sharon Hecker
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  10. Marc D. Schwartz
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Correspondence to Suzanne C. O’Neill.

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O’Neill, S.C., Valdimarsdottir, H.B., DeMarco, T.A. et al. BRCA1/2 test results impact risk management attitudes, intentions, and uptake. Breast Cancer Res Treat 124, 755–764 (2010). https://doi.org/10.1007/s10549-010-0881-4

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  • DOI: https://doi.org/10.1007/s10549-010-0881-4

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