Risk-Reduction Surgery Decisions in High-Risk Women Seen for Genetic Counseling
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Women at greatest risk for hereditary breast and ovarian cancer may consider prophylactic removal of breasts or ovaries as a risk-reduction measure. This report describes uptake of risk-reduction mastectomy (RRM), risk-reduction oophorectomy (RRO), and related factors in 62 high-risk women who received genetic counseling. Seven (11%) participants underwent RRM and 13 (21%) underwent RRO. Of these women, 37% did not have BRCA testing, suggesting other factors influence decisions to undergo surgery. Women who had indicated (pre-genetic counseling) their intent not to have surgery chose not to have surgery. Information received during genetic counseling that women perceived as being most important for influencing risk-reduction surgery decisions was BRCA test result (positive or negative), followed by discussion of family cancer history. Reasons for indecision about risk-reduction surgery included genetic testing results, concerns about surgery, timing in life, and early menopause. The findings enhance our understanding of information that is helpful to women considering this surgery.
- Armstrong, K., Schwartz, J. S., Randall, T., Rubin, S. C., & Weber, B. (2004). Hormone replacement therapy and life expectancy after prophylactic oophorectomy in women with BRCA1/2 mutations: a decision analysis. J Clin Oncol, 22, 1045–1054.
- Barnes-Kedar, I. M., & Plon, S. E. (2002). Counseling the at risk patient in the BRCA1 and BRCA2 Era. Obstet Gynecol Clin North Am, 29, 341–366, vii.
- Byrne, C., Brinton, L. A., Haile, R. W., & Schairer, C. (1991). Heterogeneity of the effect of family history on breast cancer risk. Epidemiology, 2, 276–284.
- Claus, E. B., Risch, N., & Thompson, W. D. (1991). Genetic analysis of breast cancer in the cancer and steroid hormone study. Am J Hum Genet, 48, 232–242.
- Colditz, G. A., Willett, W. C., Hunter, D. J., Stampfer, M. J., Manson, J. E., Hennekens, C. H., et al. (1993). Family history, age, and risk of breast cancer. Prospective data from the Nurses' Health Study. Jama, 270, 338–343. CrossRef
- Cull, A., Fry, A., Rush, R., & Steel, C. M. (2001). Cancer risk perceptions and distress among women attending a familial ovarian cancer clinic. Br J Cancer, 84, 594–599. CrossRef
- Easton, D. F., Hopper, J. L., Thomas, D. C., Antoniou, A., Pharoah, P. D., Whittemore, A. S., et al. (2004). Breast cancer risks for BRCA1/2 carriers. Science, 306, 2187–2191; author reply 2187–2191.
- Egan, K. M., Stampfer, M. J., Rosner, B. A., Trichopoulos, D., Newcomb, P. A., Trentham-Dietz, A., et al. (1998). Risk factors for breast cancer in women with a breast cancer family history. Cancer Epidemiol Biomarkers Prev, 7, 359–364.
- Fry, A., Rush, R., Busby-Earle, C., & Cull, A. (2001). Deciding about prophylactic oophorectomy: what is important to women at increased risk of ovarian cancer? Prev Med, 33, 578–585. CrossRef
- Garber, J. E., & Hartman, A. R. (2004). Prophylactic oophorectomy and hormone replacement therapy: Protection at what price? J Clin Oncol, 22, 978–980. CrossRef
- Ghosh, K., & Hartmann, L. C. (2002). Current status of prophylactic mastectomy. Oncology (Huntingt), 16, 1319–1325; discussion 1325, 1329–1330, 1332.
- Haber, D. (2002). Prophylactic oophorectomy to reduce the risk of ovarian and breast cancer in carriers of BRCA mutations. N Engl J Med, 346, 1660–1662.
- Hallowell, N. (2000). A qualitative study of the information needs of high-risk women undergoing prophylactic oophorectomy. Psychooncology, 9, 486–495. CrossRef
- Hartman, A. R., Daniel, B. L., Kurian, A. W., Mills, M. A., Nowels, K. W., Dirbas, F. M., et al. (2004). Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma. Cancer, 100, 479–489. CrossRef
- Hartmann, L. C., Degnim, A., & Schaid, D. J. (2004). Prophylactic mastectomy for BRCA1/2 carriers: progress and more questions. J Clin Oncol, 22, 981–983. CrossRef
- Irwig, L., Houssami, N., & van Vliet, C. (2004). New technologies in screening for breast cancer: a systematic review of their accuracy. Br J Cancer, 90, 2118–2122.
- Kauff, N. D., Satagopan, J. M., Robson, M. E., Scheuer, L., Hensley, M., Hudis, C. A., et al. (2002). Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med, 346, 1609–1615. CrossRef
- King, M. C. (2004). Breast cancer risks for BRCA1/2 carriers. Science, 306, 2188–2191.
- Krippendorf, K. (1980). Content analysis: An introduction to its methodology. Beverly Hills, CA: Sage Publications.
- Lerman, C., Hughes, C., Croyle, R. T., Main, D., Durham, C., Snyder, C., et al. (2000). Prophylactic surgery decisions and surveillance practices one year following BRCA1/2 testing. Prev Med, 31, 75–80. CrossRef
- Lynch, H. T., & Casey, M. J. (2001). Current status of prophylactic surgery for hereditary breast and gynecologic cancers. Curr Opin Obstet Gynecol, 13, 25–30. CrossRef
- Lynch, H. T., Lynch, J. F., & Rubinstein, W. S. (2001). Prophylactic mastectomy: obstacles and benefits. J Natl Cancer Inst, 93, 1586–1587. CrossRef
- Meijers-Heijboer, H., van Geel, B., van Putten, W. L., Henzen-Logmans, S. C., Seynaeve, C., Menke-Pluymers, M. B., et al. (2001). Breast cancer after prophylactic bilateral mastectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med, 345, 159–164. CrossRef
- Moller, P., Borg, A., Evans, D. G., Haites, N., Reis, M. M., Vasen, H., et al. (2002). Survival in prospectively ascertained familial breast cancer: analysis of a series stratified by tumour characteristics, BRCA mutations and oophorectomy. Int J Cancer, 101, 555–559.
- Morice, P., Pautier, P., & Delaloge, S. (2001). Prophylactic surgery in patients with inherited risk of ovarian cancer. Gynecologic Oncology, 83, 445–447.
- Morris, K. T., Johnson, N., Krasikov, N., Allen, M., & Dorsey, P. (2001). Genetic counseling impacts decision for prophylactic surgery for patients perceived to be at high risk for breast cancer. Am J Surg, 181, 431–433.
- NCCN. (2003). Guidelines for detection, prevention and risk reduction of cancer. Genetics/familial high risk assessment.National Comprehensive Cancer Network, from www.nccn.org
- Petit, J. Y., & Greco, M. (2002). Quality control in prophylactic mastectomy for women at high risk of breast cancer. Eur J Cancer, 38, 23–26. CrossRef
- Rebbeck, T. R., Friebel, T., Lynch, H. T., Neuhausen, S. L., Van't Veer, L., Garber, J. E., et al. (2004). Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J Clin Oncol, 22, 1055–1062. CrossRef
- Rebbeck, T. R., Levin, A. M., Eisen, A., Snyder, C., Watson, P., Cannon-Albright, L., et al. (1999). Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers. J Natl Cancer Inst, 91, 1475–1479. CrossRef
- Rebbeck, T. R., Lynch, H. T., Neuhausen, S. L., Narod, S. A., Van't Veer, L., Garber, J. E., et al. (2002). Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med, 346, 1616–1622. CrossRef
- Redelmeier, D. A., Rozin, P., & Kahneman, D. (1993). Understanding patients' decisions. Cognitive and emotional perspectives. Jama, 270, 72–76. CrossRef
- Rogozinska-Szczepka, J., Utracka-Hutka, B., Grzybowska, E., Maka, B., Nowicka, E., Smok-Ragankiewicz, A., et al. (2004). BRCA1 and BRCA2 mutations as prognostic factors in bilateral breast cancer patients. Ann Oncol, 15, 1373–1376. CrossRef
- Scheuer, L., Kauff, N., Robson, M., Kelly, B., Barakat, R., Satagopan, J., et al. (2002). Outcome of preventive surgery and screening for breast and ovarian cancer in BRCA mutation carriers. J Clin Oncol, 20, 1260–1268. CrossRef
- Schrag, D., Kuntz, K. M., Garber, J. E., & Weeks, J. C. (2000). Life expectancy gains from cancer prevention strategies for women with breast cancer and BRCA1 or BRCA2 mutations. Jama, 283, 617–624. CrossRef
- Sifri, R., Gangadharappa, S., & Acheson, L. S. (2004). Identifying and testing for hereditary susceptibility to common cancers. CA Cancer J Clin, 54, 309–326. CrossRef
- Smith, R. A., Saslow, D., Sawyer, K. A., Burke, W., Costanza, M. E., Evans, W. P., 3rd, et al. (2003). American Cancer Society guidelines for breast cancer screening: update 2003. CA Cancer J Clin, 53, 141–169.
- SPSS. (2004). SPSS advanced models™ 12.0. Chicago, IL: SPSS, Inc.
- Stalmeier, P., Unic, I., Verhoef, L., & Van Daal, W. (1999). Evaluation of a shared decision making program for women suspected to have a genetic predisposition to breast cancer. Medical Decision Making, 19, 230–241.
- Stefanek, M., Hartmann, L., & Nelson, W. (2001). Risk-reduction mastectomy: clinical issues and research needs. J Natl Cancer Inst, 93, 1297–1306. CrossRef
- Thull, D. L., & Vogel, V. G. (2004). Recognition and management of hereditary breast cancer syndromes. Oncologist, 9, 13–24. CrossRef
- Wacholder, S., Struewing, J. P., Hartge, P., Greene, M. H., & Tucker, M. A. (2004). Breast cancer risks for BRCA1/2 carriers. Science, 306, 2187–2191; author reply 2187–2191.
- Weinstein, N. D., & Sandman, P. M. (2002). The precaution adoption process model. In K. Glanz, Rimer, B. K., Lewis, F. M. (Ed.), Health behavior and education. San Francisco: Jossey-Bass.
- Wood, W. C. (2004). Advising women at high risk of breast cancer. Oncology (Huntingt), 18, 28–32; discussion 32–24, 39, 42.
- Risk-Reduction Surgery Decisions in High-Risk Women Seen for Genetic Counseling
Journal of Genetic Counseling
Volume 14, Issue 6 , pp 473-484
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links
- hereditary breast/ovarian cancer
- risk-reduction surgery
- prophylactic mastectomy
- prophylactic oophorectomy
- genetic counseling
- genetic testing
- precaution adoption process
- Industry Sectors