The impact of genetic counselling on risk perception and mental health in women with a family history of breast cancer

Abstract Background Current international guidelines recommend systemic hormone therapy (HT) to oophorectomized women until the age of natural menopause. Despite an inherited predisposition to estrogen-dependent malignancies, the guidelines also apply to women oophorectomized because of a family history of cancer. The objective of this study was to investigate the impact of HT on mortality and risk of cancer in women oophorectomized because of a family history of cancer. Methods A nationwide, population-based cohort was used to study women oophorectomized because of a family history of cancer (n = 2002). Comparison cohorts included women from the background population individually matched on age (n = 18 018). Oophorectomized women were subdivided into three groups: oophorectomized at 1) age 45 years or younger not using HT, 2) age 45 years or younger using HT, 3) older than age 45 years, and their respective population comparison cohorts. Results Women oophorectomized at age 45 years or younger using HT had increased overall mortality (mortality rate ratio [MRR] = 3.45, 95% confidence interval [CI] = 1.53 to 7.79), mortality because of cancer (MRR = 5.67, 95% CI = 1.86 to 17.34), and risk of overall cancer (incidence rate ratio [IRR] = 3.68, 95% CI = 1.93 − 6.98), primarily reflected in an increased risk of breast cancer (IRR = 4.88, 95% CI = 2.19 − 10.68). Women oophorectomized at age 45 years or younger not using HT and women oophorectomized at older than age 45 years did not have increased mortality, mortality because of cancer, or risk of overall cancer, but they had increased risk of breast cancer (IRR = 2.64, 95% CI = 1.14 to 6.13, and IRR = 1.72, 95% CI = 1.14 to 2.59, respectively). Conclusions Use of HT in women oophorectomized at age 45 years or younger with a family history of cancer is associated with increased mortality and risk of overall cancer and breast cancer. Our study warrants further investigation to establish the impact of HT on mortality and cancer risk in oophorectomized women with a family history of cancer.

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The Impact of Family History of Breast Cancer on Knowledge, Attitudes, and Early Detection Practices of Mexican Women Along the Mexico-US Border

Journal of Immigrant and Minority Health ◽

10.1007/s10903-010-9418-5 ◽

2010 ◽

Vol 13 (5) ◽

pp. 867-875 ◽

Cited By ~ 11

Author(s):

Yelena Bird ◽

Matthew P. Banegas ◽

John Moraros ◽

Sasha King ◽

Surasri Prapasiri ◽

...

Keyword(s):

Breast Cancer ◽

Family History ◽

Early Detection ◽

Mexican Women ◽

History Of ◽

The Impact

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The Impact of a Family History of Breast Cancer on Screening Practices and Attitudes in Low-Income, Rural, African American Women

Journal of Women s Health ◽

10.1089/154099903322447747 ◽

2003 ◽

Vol 12 (8) ◽

pp. 779-787 ◽

Cited By ~ 18

Author(s):

Delia Smith West ◽

Paul G. Greene ◽

Polly P. Kratt ◽

Leavonne Pulley ◽

Heidi L. Weiss ◽

...

Keyword(s):

Breast Cancer ◽

African American ◽

Family History ◽

African American Women ◽

Low Income ◽

American Women ◽

Screening Practices ◽

History Of ◽

The Impact

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The Impact of Family History of Breast Cancer on Women's Health Beliefs, Salience of Breast Cancer Family History, and Degree of Involvement in Breast Cancer Issues

Women & Health ◽

10.1300/j013v33n03_02 ◽

2001 ◽

Vol 33 (3-4) ◽

pp. 17-31 ◽

Cited By ~ 14

Author(s):

Lila J. Finney ◽

Ronald J. Iannotti

Keyword(s):

Breast Cancer ◽

Family History ◽

Women's Health ◽

Health Beliefs ◽

Breast Cancer Family ◽

Cancer Family ◽

Cancer Family History ◽

History Of ◽

The Impact ◽

Breast Cancer Family History

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The impact of information given to patients’ families: Breast cancer risk notification

Análise Psicológica ◽

10.14417/ap.275 ◽

2012 ◽

Vol 20 (1) ◽

pp. 27-34

Author(s):

Estrella Durá Ferrandis ◽

Yolanda Andreu ◽

Maria José Galdón

Keyword(s):

Breast Cancer ◽

At Risk ◽

Family History ◽

Health Beliefs ◽

Close Relative ◽

Screening Methods ◽

First Degree Relatives ◽

Preventive Practices ◽

History Of ◽

The Impact

A family history of breast cancer is a clear risk for developing the disease. Therefore, when a woman is diagnosed with breast cancer all her female first degree relatives become population at risk. This involve a number of important aspects to be taken into account by psychooncology professionals. (a) First, in addition to the stress associated with the diagnosis and treatment of breast cancer in a close relative, first degree relatives of breast cancer patients have the added stress of learning that they are at risk of this disease. (b) Second, these women become the main target of secondary breast cancer prevention strategies. However, various reports show that a considerable percentage of these women do not follow the recommended screening methods. For this reason, it is necessary to study the possible contribution of psychosocial factors, specially health beliefs, in the practice of preventive behavior aimed at preventing breast cancer in this population, and to design strategies to promote preventive practices. (c) Most of the research on health beliefs among women at risk for breat cancer has focused on risk perception.This research as found that some women with a family history of breast cancer have significantly overestimated their risk, while other shave underestimated their risk. The need to provide risk counselling schemes for these women is therefore proposed, in order to estimate and advise them of their real risk. (d) Finally, these women may request genetic testing to determine whether they carry genetic mutations (BRCA1, BRCA2, or others) that cause some types of breast cancer. However, it must be remembered that, although many first degree relatives will have heard of and seek «the cancer gene test», currently testing is appropiate and available only for rare individuals. All these issues are reviewed in the present paper.

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