Attitude towards genetic testing for breast cancer susceptibility: a comparison of affected and unaffected women
Corresponding Author
M. BRUNO md
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Michele BRUNO, Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy (e-mail: [email protected]). Search for more papers by this authorM. DIGENNARO md
Unit of Senology, Woman Department, Cancer Institute of Bari, Bari
Search for more papers by this authorS. TOMMASI bs
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorB. STEA msis
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorT. DANESE psyd
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorF. SCHITTULLI md
Unit of Senology, Woman Department, Cancer Institute of Bari, Bari
Search for more papers by this authorA. PARADISO md
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorCorresponding Author
M. BRUNO md
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Michele BRUNO, Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy (e-mail: [email protected]). Search for more papers by this authorM. DIGENNARO md
Unit of Senology, Woman Department, Cancer Institute of Bari, Bari
Search for more papers by this authorS. TOMMASI bs
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorB. STEA msis
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorT. DANESE psyd
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorF. SCHITTULLI md
Unit of Senology, Woman Department, Cancer Institute of Bari, Bari
Search for more papers by this authorA. PARADISO md
Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy
Search for more papers by this authorAbstract
BRUNO M., DIGENNARO M., TOMMASI S., STEA B., DANESE T., SCHITTULLI F. & PARADISO A. (2010) European Journal of Cancer Care19, 360–368Attitude towards genetic testing for breast cancer susceptibility: a comparison of affected and unaffected women
The objective of this study is to evaluate women's awareness and interest in genetic testing for breast cancer risk, to identify socio-demographic factors, to analyse the reasons for wanting or not wanting to be tested and finally to determine whether breast cancer patients and healthy women have different attitudes towards genetic testing. Consecutive series of 879 women without and with breast cancer participated in a 20-item self-completing questionnaire. Among breast cancer patients, 57% answered that they would definitely or probably accept being tested, compared with 84% of women without breast cancer. At the multiple logistic regression analysis only to have a diagnosis of breast cancer conditioned significantly the interest to have genetic testing. Surprisingly, a family history of breast cancer was found to have no significant impact. The most frequently cited reason for being interested in genetic testing was ‘to learn about your children's risk’. Although women's awareness about breast cancer genes is inadequate, the interest in genetic testing is substantial and higher both in healthy women and in women with breast cancer. These results provide important indications for the development of educational strategies.
REFERENCES
- Andrykowski M.A., Munn R.K. & Studts J.L. (1996) Interest in learning of personal genetic risk for cancer: a general population survey. Preventive Medicine 25, 527–536.
- Andrykowski M.A., Lightner R., Studts J.L. & Munn R.K. (1997) Hereditary cancer risk notification and testing: how interested is the general population? Journal of Clinical Oncology 15, 2139–2148.
- Antoniou A., Pharoah P.K.P., Narod S., Risch H.A., Eyfjord J.E., Hopper J.L., Loman N., Olsson H., Johannsson O., Borg A., Pasini B., Radice P., Manoukian S., Eccles D.M., Tang N., Olah E., Anton-Culver H., Warner E., Lubinski J., Gronwald J., Gorski B., Tulinius H., Thorlacius S., Eerola H., Nevanlinna H., Syrjakoski K., Kallioniemi O.P., Thompson D., Evans C., Peto J., Lalloo F., Evans D.G. & Easton D.F. (2003) Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. American Journal of Human Genetics 72, 1117–1130.
- Armstrong K., Calzone K., Stopfer J., Fitzgerald G., Coyne J. & Weber B. (2000) Factors associated with decisions about clinical BRCA1/2 testing. Cancer Epidemiology, Biomarkers and Prevention 9, 1251–1254.
- Bottorff J.L., Ratner P.A., Balneaves L.G., Richardson C.G., McCullum M., Hack T., Chalmers K. & Buxton J. (2002) Women's interest in genetic testing for breast cancer risk: the influence of socio-demographics and knowledge. Cancer Epidemiology, Biomarkers and Prevention 11, 89–95.
-
Brose M.S.,
Rebbeck D.R.,
Calzone K.A.,
Stopfer J.E.,
Nathanson K.L. &
Weber B.L. (2002) Cancer risk estimates for BRCA1 mutation carriers identified in a risk evaluation program.
Journal of the National Cancer Institute
94, 1365–1372.
10.1093/jnci/94.18.1365 Google Scholar
-
Bruno M.,
Tommasi S.,
Stea B.,
Quaranta M.,
Schittulli F.,
Mastropasqua A.,
Distante A.,
Di Paola L. &
Paradiso A. (2004) Awareness of breast cancer genetics and interest in predictive genetic testing: a survey of a southern Italian population.
Annals of Oncology
15 (Suppl.
1), i48–i54.
10.1093/jnci/94.18.1365 Google Scholar
-
Cappelli M.,
Surh L.,
Humphreys L.,
Verma S.,
Logan D.,
Hunter A. &
Allanson J. (1999) Psychological and social determinants of women's decisions to undergo genetic counselling and testing for breast cancer.
Clinical Genetics
55, 419–430.
10.1034/j.1399-0004.1999.550605.x Google Scholar
-
Chaliki H.,
Loader S.,
Levenkron J.C.,
Logan-Young W.,
Hall W.J. &
Rowley P.T. (1995) Women's receptivity to testing for a genetic susceptibility to breast cancer.
American Journal of Public Health
85, 1133–1135.
10.1034/j.1399-0004.1999.550605.x Google Scholar
- Donovan K.A. & Tucker D.C. (2000) Knowledge about genetic risk for breast cancer and perceptions of genetic testing in a socio-demographically diverse sample. Journal of Behavioral Medicine 23, 15–36.
- Geller G., Doksum T., Bernhardt B.A. & Metz S.A. (1999) Participation in breast cancer susceptibility testing protocols: influence of recruitment source, altruism and family involvement on women's decisions. Cancer Epidemiology, Biomarkers and Prevention 8, 377–383.
- Gwyn K., Vernon S.W. & Conoley P.M. (2003) Intention to pursue genetic testing for breast cancer among women due for screening mammography. Cancer Epidemiology, Biomarkers and Prevention 12, 96–102.
- Halbert H.C. (2004) Decisions and outcomes of genetic testing for inherited breast cancer risk. Annals of Oncology 15 (Suppl. 1), i35–i39.
- Hartmann L.C., Sellers T.A., Schaid D.J., Frank T.S., Soderberg C.L., Sitta D.L., Frost M.H., Grant C.S., Donohue J.H., Woods J.E., McDonnell S.K., Vockley C.W., Deffenbaugh A., Couch F.J. & Jenkins R.B. (2001) Efficacy of prophylactic mastectomy in BRCA1 and BRCA2 gene mutation carriers. Journal of the National Cancer Institute 93, 1633–1637.
- Julian-Reynier C., Eisinger F., Vennin P., Chabal F., Aurran Y., Nogues C., Bignon Y.J., Machelard-Roumagnac M., Maugard-Louboutin C., Serin D., Blanc B., Orsoni P. & Sobol H. (1996) Attitudes towards cancer predictive testing and transmission of information to the family. Journal of Medical Genetics 33, 731–736.
-
Kash K.M.,
Ortega-Verdejo K.,
Dabney M.K.,
Holland J.C.,
Miller D.G. &
Osborne M.P. (2000) Psychological aspects of cancer genetics: women at high risk for breast and ovarian cancer.
Seminars in Surgical Oncology
18, 333–338.
10.1002/(SICI)1098-2388(200006)18:4<333::AID-SSU8>3.0.CO;2-4 Google Scholar
-
Lerman C.,
Daly M.,
Masny A. &
Balshem A. (1994) Attitudes about genetic testing for breast-ovarian cancer susceptibility.
Journal of Clinical Oncology
12, 843–850.
10.1002/(SICI)1098-2388(200006)18:4<333::AID-SSU8>3.0.CO;2-4 CAS PubMed Web of Science® Google Scholar
- Lerman C., Seay J., Balshem A. & Audrain J. (1995) Interest in genetic testing among first-degree relatives of breast cancer patients. American Journal of Medical Genetics 57, 385–392.
- Lipkus I.M., Iden D., Terenoire J. & Feaganes J.R. (1999) Relationship among breast cancer concern, risk perceptions, and interest in genetic testing for breast cancer susceptibility among African-American women with and without family history of breast cancer. Cancer Epidemiology, Biomarkers and Prevention 8, 533–539.
- Ludman E.J., Curry S.J., Hoffman E. & Taplin S. (1999) Women's knoledge and attitudes about genetic testing for breast cancer susceptibility. Effective Clinical Practice 2, 158–162.
- Lynch H.T., Snyder C.L., Lynch J.F., Riley B.D. & Rubinstein W.S. (2003) Hereditary breast-ovarian cancer at the bedside: role of the medical oncologist. Journal of Clinical Oncology 21, 740–753.
- Meijers-Heijboer E.J., Verhoog L.C., Brekelmans C.T., Seynaeve C., Tilanus-Linthorst M.M., Wagner A., Dukel L., Devilee P., Van Den Ouweland A.M., Van Geel A.N. & Klijn J.G. (2000) Presymptomatic DNA testing and prophylactic surgery in families with a BRCA1 or BRCA2 mutation. Lancet 355, 2015–2020.
- Mogilner A., Otten M., Cunningham J.D. & Brower S.T. (1998) Awareness and attitudes concerning BRCA gene testing. Annals of Surgical Oncology 5, 607–612.
- Narod S.A. (2001) Hormonal prevention of hereditary breast cancer. Annals of the New York Academy of Sciences 952, 36–43.
-
Press N.A.,
Yasui Y.,
Reynolds S.,
Durfy S.J. &
Burke W. (2001) Women's interest in genetic testing for breast cancer susceptibility may be based on unrealistic expectations.
American Journal of Medical Genetics
99, 99–110.
10.1002/1096-8628(2000)9999:999<00::AID-AJMG1142>3.0.CO;2-I CAS PubMed Web of Science® Google Scholar
-
Rebbeck T.R.,
Levin A.M.,
Eisen A.,
Snyder C.,
Watson P.,
Cannon-Albright L.,
Isaacs C.,
Olopade O.,
Garber J.E.,
Godwin A.K.,
Daly M.B.,
Narod S.A.,
Neuhausen S.L.,
Lynch H.T. &
Weber B.L. (1999) Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers.
Journal of the National Cancer Institute
91, 1475–1479.
10.1002/1096-8628(2000)9999:999<00::AID-AJMG1142>3.0.CO;2-I Google Scholar
-
Scheuer L.,
Kauff N.,
Robson M.,
Kelly B.,
Barakat R.,
Satagopan J.,
Ellis N.,
Hensley M.,
Boyd J.,
Borgen P.,
Norton L. &
Offit K. (2002) Outcome of preventive surgery and screening for breast and ovarian cancer in BRCA mutation carriers.
Journal of Clinical Oncology
20, 1260–1268.
10.1200/JCO.2002.20.5.1260 Google Scholar
-
Schwartz M.D.,
Benkendorf J.,
Lerman C.,
Isaacs C.,
Ryan-Robertson A. &
Johnson L. (2001) Impact of educational print materials on knowledge, attitudes and interest in BRCA1/BRCA2: testing among Ashkenazi Jewish women.
Cancer
92, 932–940.
10.1002/1097-0142(20010815)92:4<932::AID-CNCR1403>3.0.CO;2-Q CAS PubMed Web of Science® Google Scholar
-
Smith J.A. &
Andreopoulou E. (2004) An overview of the status of imaging screening technology for breast cancer.
Annals of Oncology
15 (Suppl.
1), i18–i26.
10.1002/1097-0142(20010815)92:4<932::AID-CNCR1403>3.0.CO;2-Q CAS PubMed Web of Science® Google Scholar
-
Struewing J.P.,
Lerman C.,
Kase R.G.,
Giambarresi T.R. &
Tucker M.A. (1995) Anticipated uptake and impact of genetic testing in hereditary breast and ovarian cancer families.
Cancer Epidemiology, Biomarkers and Prevention
4, 169–173.
10.1093/annonc/mdh653 Google Scholar
-
Tambor E.S.,
Rimer B.K. &
Strigo T.S. (1997) Genetic testing for breast cancer susceptibility: awareness and interest among women in general population.
American Journal of Medical Genetics
68, 43–49.
10.1002/(SICI)1096-8628(19970110)68:1<43::AID-AJMG8>3.0.CO;2-Z PubMed Web of Science® Google Scholar