Surveillance Behavior and Prophylactic Surgery After Predictive Testing for Hereditary Breast/Ovarian Cancer

• Published in: Behavioral medicine (Washington, D.C.) Vol. 31; no. 3; pp. 93 - 106
• Main Authors: Claes, Erna, Evers-Kiebooms, Gerry, Decruyenaere, Marleen, Denayer, Lieve, Boogaerts, Andrea, Philippe, Kristien, Legius, Eric
• Format: Journal Article
• Language: English
• Published: Washington, DC Heldref 01.09.2005; Taylor & Francis Inc
• Subjects: Adult; Area Studies; Belgium; Biological and medical sciences; Breast cancer; Breast Neoplasms - genetics; Breast Neoplasms - prevention & control; Breast Self-Examination - psychology; Cancer; Cultural Differences; Decision Making; DNA Mutational Analysis; Emotional Response; Female; Females; Fundamental and applied biological sciences. Psychology; Genes, BRCA1; Genes, BRCA2; Genetic Carrier Screening; Genetic Counseling - psychology; Genetic Testing - psychology; Health behavior; Health Knowledge, Attitudes, Practice; Humans; Illness and personality; Longitudinal Studies; Mammaplasty - psychology; Mammography - psychology; Mastectomy - psychology; Medical sciences; Medical screening; Medical Services; Mental health; Middle Aged; Outcome Measures; Ovarian cancer; Ovarian Neoplasms - genetics; Ovarian Neoplasms - prevention & control; Ovarian Neoplasms - psychology; Patient Acceptance of Health Care - psychology; Personality, behavior and health; Predictive ability; predictive testing; Prevention. Health policy. Planification; Prophylactic mastectomy; prophylactic surgery; Psychological Patterns; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology. Psychiatry; Sick Role; Social psychiatry. Ethnopsychiatry; Surgery; Surveillance; surveillance behavior; Test Results; Testing Programs; Belgium; Europe; Social environment; High risk; Ovary cancer; Mental health; Genetic determinism; prophylactic surgery; Prevention; Surgery; Genetics; Female; Treatment compliance; BRCA1 gene; Public health; Human; Clinical test; Decision making; ovarian cancer; Breast cancer; Malignant tumor; Medical screening; Recommendation; Female genital diseases; Genetic disease; predictive testing; Mammary gland diseases; Ovarian diseases; Treatment; Surveillance; BRCA2 gene; Comparative study; surveillance behavior
• DOI: 10.3200/BMED.31.3.93-106
• ISSN: 0896-4289

This article describes breast or ovarian cancer surveillance practices and prophylactic surgery involving 34 carriers and 34 noncarriers of a BRCA1/2 mutation within the year after predictive testing. It also evaluates the effect of the predictive test result on cancer screening practices and provides insight into factors important in the decision-making process about health-related behavior. Within the year following predictive testing, 9% (3 of 34) of the carriers decided to have a prophylactic mastectomy. The majority of the carriers was adherent to recommendations regarding regular cancer surveillance following predictive testing. Furthermore, carriers' adherence to clinical breast examination and mammography recommendations significantly increased from pre- to posttest and was significantly higher than noncarriers' utilization after testing. Of the carriers eligible for prophylactic salpingo-oophorectomy, 75% had this operation. All carriers who were advised to have regular surveillance of the ovaries had ovarian ultrasounds. The authors gave major attention to factors playing a part in the decision-making process about health-related behavior.