scholarly journals Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic

2014 ◽  
Vol 110 (7) ◽  
pp. 1681-1687 ◽  
Author(s):  
L S Donnelly ◽  
D G Evans ◽  
J Wiseman ◽  
J Fox ◽  
R Greenhalgh ◽  
...  
2015 ◽  
Vol 13 (5) ◽  
pp. 1441-1448 ◽  
Author(s):  
Sarah R. Ormseth ◽  
David K. Wellisch ◽  
Adam E. Aréchiga ◽  
Taylor L. Draper

AbstractObjective:The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic.Method:Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES–D score ≥ 16), current level of anxiety (State–Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer).Results:A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted “U” relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels.Significance of Results:Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.


2006 ◽  
Vol 5 (9) ◽  
pp. 1098-1102 ◽  
Author(s):  
Gabriel A. Brooks ◽  
Jill E. Stopfer ◽  
Julie Erlichman ◽  
Rebecca Davidson ◽  
Katherine L. Nathanson ◽  
...  

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10013-10013
Author(s):  
G. A. Brooks ◽  
J. E. Stopfer ◽  
J. Erlichman ◽  
R. Davidson ◽  
K. L. Nathanson ◽  
...  

10013 Background: Germline mutations in the BRCA1 and BRCA2 genes (BRCA1/2) are associated with breast cancer, ovarian cancer and other malignancies. Biallelic mutations of BRCA2 are a cause of Fanconi anemia and characteristic childhood cancers. We undertook this study to evaluate the contribution of familial heterozygous BRCA1/2 mutations to childhood cancer in hereditary breast cancer families. Methods: We conducted a retrospective cohort study to compare the prevalence of childhood cancers among 379 families with BRCA1/2 mutations and 426 families without known mutations. All families were ascertained at a high-risk breast cancer clinic. Our study and comparison cohorts included first- through fourth-degree relatives of cancer-affected mutation carriers and cancer-affected individuals with negative full sequencing for BRCA1/2 mutations. The primary endpoint was any case of childhood cancer (diagnosed <age 21) as recorded in the family history. Results were analyzed using Fisher’s exact test. Results: 20 cases of childhood cancer were observed in 379 families with BRCA1/2 mutations and 35 cases of childhood cancer were observed in 426 families with negative mutation testing (p = 0.12). Apart from two very early-onset breast cancers, the types of childhood cancers occurring in the BRCA1/2 mutation positive families were similar to those occurring in the mutation negative families and in the general population. Nine childhood cancers occurred in 240 families with BRCA1 mutations, and 11 childhood cancers occurred in 141 families with BRCA2 mutations (p=0.1). 13 of 18 BRCA1/2 mutation positive families with cases of childhood cancer (72%) and 13 of 31 families with childhood cancer cases and negative mutation testing (42%) met the Birch clinical criteria for Li-Fraumeni like syndrome (LFL); no individual has undergone testing for germline TP53 mutations. Conclusions: Heterozygous BRCA1/2 mutations do not appear to be a significant risk factor for childhood cancer in hereditary breast cancer families. This observation supports the current practice of delaying BRCA1/2 mutation testing until candidates reach adulthood. Although many families in both groups met criteria for LFL, the clinical significance of this finding is uncertain. No significant financial relationships to disclose.


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