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Psychological consequences of MRI-based screening among women with strong family histories of breast cancer

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

MRI-based screening in women with a ≥ 25% lifetime risk of breast cancer , but no identifiable genetic mutations may be associated with false positives. This study examined the psychological impact of abnormal screens and biopsies in non-mutation carriers participating in high-risk screening with no personal history of breast cancer.

Methods

Non-mutation carriers participating in the High-Risk Ontario Breast Screening Program at two sites were mailed demographic surveys, psychological scales, and chart review consent. Scales included the Consequences of Screening in Breast Cancer questionnaire, Lerman Breast Cancer Worry Scale, and Worry Interference Scale. Missing data were managed with multiple imputation. Multivariable regression was used to assess whether abnormal screens or biopsies were associated with adverse psychological effects.

Results

After contacting 465 participants, 169 non-mutation carriers were included. Median age was 46 years (range 30–65). Over a median 3 years of screening, 63.9% of women experienced at least one abnormal screen, and 24.9% underwent biopsies. Statements relating to cancer worry/anxiety scored highest, with 19.5% indicating they worried “a lot”. Higher scores among anxiety-related statements were strongly associated with higher dejection scores. Overall, coping and daily functioning were preserved. Women indicated some positive reactions to screening, including improved existential values and reassurance they do not have breast cancer. Abnormal screens and biopsies were not significantly associated with any psychological scale, even after adjustment for patient characteristics.

Conclusion

Non-mutation carriers undergoing MRI-based screening had considerable baseline anxiety and cancer worry, although daily functioning was not impaired. Abnormal screens and biopsies did not appear to have adverse psychological effects.

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Data availability

Due to the nature of this research, participants of this study did not explicitly agree for their data to be shared publicly, so supporting data are not available.

Code availability

Available upon request.

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Funding

Cancer Care Ontario, Achieving Excellence in Cancer Care Project Award (2015).

Author information

Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Matthew Castelo & Adena S. Scheer

  2. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Matthew Castelo, Bettina E. Hansen & Adena S. Scheer

  3. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Matthew Castelo & Adena S. Scheer

  4. Department of Surgery, St. Michael’s Hospital, Toronto, ON, Canada

    Matthew Castelo & Adena S. Scheer

  5. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Zachary Brown

  6. Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Josephine A. D’Abbondanza

  7. Division of General Surgery, Department of Surgery, Health Sciences North, Sudbury, ON, Canada

    Nastasia V. Wasilewski

  8. Northern Ontario School of Medicine, Sudbury, ON, Canada

    Nastasia V. Wasilewski

  9. Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Andrea Eisen

  10. Department of Medical Imaging, St. Michael’s Hospital, Toronto, ON, Canada

    Derek Muradali

  11. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Eva Grunfeld

  12. Division of General Surgery, St. Michael’s Hospital, 3-005 Donnelly Wing, 30 Bond St, Toronto, ON, M5B 1W8, Canada

    Adena S. Scheer

Authors
  1. Matthew Castelo
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  2. Zachary Brown
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  3. Josephine A. D’Abbondanza
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  8. Eva Grunfeld
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  9. Adena S. Scheer
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Corresponding author

Correspondence to Adena S. Scheer.

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The authors declare that they have no conflict of interest.

Ethical approval

The Research Ethics Boards at St. Michael’s Hospital (#15-168) and Sunnybrook Health Sciences Center (#397-2016) reviewed and approved this study.

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Castelo, M., Brown, Z., D’Abbondanza, J.A. et al. Psychological consequences of MRI-based screening among women with strong family histories of breast cancer. Breast Cancer Res Treat 189, 497–508 (2021). https://doi.org/10.1007/s10549-021-06300-w

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  • DOI: https://doi.org/10.1007/s10549-021-06300-w

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