Medline ® Abstract for Reference 7
of 'Genetic counseling and testing for hereditary breast and ovarian cancer'
Long-term reactions to genetic testing for BRCA1 and BRCA2 mutations: does time heal women's concerns?
Halbert CH, Stopfer JE, McDonald J, Weathers B, Collier A, Troxel AB, Domchek S
J Clin Oncol. 2011 Nov;29(32):4302-6. Epub 2011 Oct 11.
PURPOSE: Short-term reactions to BRCA1 and BRCA2 (BRCA1/2) genetic test results have been described in several reports, but the long-terms effects of testing have not been examined extensively.
METHODS: We conducted an observational study to characterize the long-term impact of genetic testing for BRCA1/2 mutations in 167 women who had received genetic test results at least 4 years ago. We also evaluated the relationship between genetic testing-specific reactions and breast and ovarian cancer screening to determine the behavioral significance of adverse reactions.
RESULTS: Seventy-four percent of women were not experiencing any distress regarding their test result, 41% were not experiencing any uncertainty, and 51% had a score for positive experiences that was suggestive of low levels of adverse reactions in terms of family support and communication. Mutation carriers (odds ratio, 3.96; 95% CI, 1.44 to 10.89; P = .01) were most likely to experience distress. Only less time since disclosure was related significantly to experiencing uncertainty (odds ratio,0.62; 95% CI, 0.44 to 0.88; P = .008). In terms of cancer screening, 81% of women had a mammogram during the year before study enrollment, 25% had magnetic resonance imaging (MRI), 20% had a transvaginal ultrasound, and 20% had a CA-125. Experiencing distress was associated significantly with having a CA-125 (χ(2) = 3.89, P = .05), and uncertainty was associated with having an MRI (χ(2) = 8.90, P = .003).
CONCLUSION: Our findings show that women are not likely to experience genetic testing concerns several years after receiving BRCA1/2 test results; distress and uncertainty are not likely to have adverse effects on screening among women at risk for hereditary disease.
University of Pennsylvania, 3535 Market St, Ste 4100, Philadelphia, PA 19104, USA. Chanita@mail.med.upenn.edu