Abstract
The burden and experiences that come with a breast cancer diagnosis in a family impact how women perceive personal cancer risk and pursue preventive strategies and/or early detection screening. Hence, this study sought to understand how Filipino women incorporate their experiences living with a sister diagnosed with early-onset breast cancer to their personal perceived risk and screening behavior. Guided by phenomenological approach of inquiry, a face-to-face, semi-structured interview was conducted with 12 purposively sampled women with a female sibling diagnosed with breast cancer before age 50. Transcripts were analyzed using thematic analysis. Results revealed that the respondents tend to compare themselves with their sister when constructing views of personal cancer vulnerability. The subjective risk is also shaped by their beliefs regarding cancer causation such as personalistic causes, personal theory of inheritance, and locus of control. Their sisters’ cancer diagnoses serve as a motivation for them to perform breast self-examination. However, clinical breast examination and screening mammography are underutilized due to perceived barriers such as difficulty allotting time to medical consultation, fear, and lack of finances. Overall, cancer risk perception and screening behavior are important factors that must be addressed during cancer genetic counseling consultations. Better understanding of these factors will aid in the formulation of an effective management plan for at-risk women.
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References
Abad PJ (2012) Explanatory models of illness may facilitate cultural competence in genetic counseling. J Genet Couns 21:612–614. https://doi.org/10.1007/s10897-012-9487-9
Abad PJ, Tan M, Baluyot MM, Villa A, Talapian GL, Reyes ME et al (2014) Cultural beliefs on disease causation in the Philippines: challenge and implications in genetic counseling. J Community Genet 5:399–407. https://doi.org/10.1007/s12687-014-0193-1
Berliner JL, Fay AM, Cummings SA, Burnett B, Tillmanns T (2012) NSGC practice guideline: risk assessment and genetic counseling for hereditary breast and ovarian cancer. J Genet Counsel 22(2):155–163
Bottorff J, Ratner P, Johnson J, Lovato C, Joab S (1998) Communicating cancer risk information: the challenges of uncertainty. Patient Educ Couns 33:67–81. https://doi.org/10.1016/S0738-3991(97)00047-5
Bray F, Ren J-S, Masuyer E, Ferlay J (2013) Global estimates of cancer prevalence for 27 sites in the adult population. Int J Cancer 132:1133–1145. https://doi.org/10.1002/ijc.27711
Brunstrom K, Murray A, McAllister M (2015) Experiences of women who underwent predictive BRCA 1/2 mutation testing before age 30. J Genet Couns 25:90–100. https://doi.org/10.1007/s10897-015-9845-5
Chalmers K, Thomson K (1996) Coming to terms with the risk of breast cancer: perceptions of women with primary relatives with breast cancer. Qual Health Res 6:256–282. https://doi.org/10.1177/104973239600600207
Chalmers K, Thomson K, Degner L (1996) Information, support and communication needs of women with a family history of breast cancer. Cancer Nurs 19:204–213. https://doi.org/10.1097/00002820-199606000-00007
Creswell JW (2014) Research design: qualitative, quantitative and mixed methods approaches, 4th edn. SAGE Publications, Thousand Oaks
d’ Agincourt-Canning L (2005) The effect of experiential knowledge on construction of risk perception in hereditary breast/ovarian cancer. J Genet Couns 14:55–69. https://doi.org/10.1007/s10897-005-1500-0
de Torres S (2002) Understanding persons of Philippine origin: a primer for rehabilitation service providers. Center for International Rehabilitation Research Information and Exchange, New York
George S (2000) Barriers to breast cancer: an integrative review. Health Care Women Int 21(1):53–65. https://doi.org/10.1080/073993300245401
Gibson L, Hery C, Mitton N, Gines-Bautista A, Parkin DM, Ngelangel C, Pisani P (2009) Risk factors for breast cancer among Filipino women in Manila. Int J Cancer 126:515–521. https://doi.org/10.1002/ijc.24769
Groenewald T (2004) A phenomenological research design illustrated. Int J Qual Methods 3:42–55. https://doi.org/10.1177/160940690400300104
Hamilton RJ, Bowers BJ (2007) The theory of genetic vulnerability: a Roy model exemplar. Nurs Sci Q 20:254–264. https://doi.org/10.1177/0894318407303127
International Agency for Research on Cancer (2013) Press release no. 233 latest world cancer statistics, global cancer burden rises to 14.1 million new cases in 2012: marked increased in breast cancer must be addressed. World Health Organization, Geneva
Kleibl Z, Kristensen V (2016) Women at high risk of breast cancer: molecular characteristics, clinical presentation and management. Breast 28:136–144. https://doi.org/10.1016/j.breast.2016.05.006
Lamyian M, Hydarnia A, Ahmadi F, Faghihzadeh S, Aguilar-Vafaire M (2007) Barriers to and factors facilitating breast cancer screening among Iranian women: a qualitative study. East Mediterr Health J 13(5):1160–1169. https://doi.org/10.26719/2007.13.5.1160
Laudico A, Medina V, Mirasol-Lumague MR, Mapua C, Redaniel MT, Valenzuela F, Pukkala E (2010) 2010 Philippine cancer facts and estimates. Philippine Cancer Society, Inc., Manila
Maheu C (2009) Implications of living with a strong family history of breast cancer. Can J Nurs Res 41(2):100–112
Matsuda ML, Liede A, Kwan E, Mapua C, Cutiongco EM, Tan A et al (2002) BRCA1 and BRCA2 mutations among breast cancer patients in the Philippines. Int J Cancer 98:596–603. https://doi.org/10.1002/ijc.10194
Maxwell A, Bastani R, Warda U (1997) Breast cancer screening and related attitudes among Filipino-American women. Cancer Epidemiol Biomark Prev 6:719–726
McAllister M (2003) Personal theories of inheritance, coping strategies, risk perception and engagement in hereditary non-polyposis colon cancer families offered genetic testing. Clin Genet 64:179–189. https://doi.org/10.1034/j.1399-0004.2003.00133.x
McBride M (2001) Health and health care of Filipino American elders. Retrieved from Stanford Geriatric Education Center: http://www.stanford.edu/group/ethnoger/filipino.html
McDowell ME, Occhipinti S, Chambers SK (2013) The influence of family history of cognitive heuristics, risk perception and prostate cancer screening behavior. Health Psychol 32:1158–1169. https://doi.org/10.1037/a0031622
Moodi M, Rezalian M, Sharifirad G-R (2012) Determinants of mammography screening behavior in Iranian women: a population-based study. J Res Med Sci 17(8):750–759
National Comprehensive Cancer Network (2017) NCCN Clinical Practice Guidelines in Oncology Genetic/Familial High Risk Assessment: Breast and Ovarian Version 2.2017. National Comprehensive Cancer Network
Ngelangel C, Wang EH (2002) Cancer and the Philippine Cancer Program. Jpn J Clin Oncol 32:552–561. https://doi.org/10.1093/jjco/hye126
Ngelangel CA, Lacaya LB, Cordero C, Laudico A (1994) Risk Factors for Breast Cancer among Filipino Women. Philipp J Intern Med 32(5):231–236
Obikunle A (2016) Barriers to breast cancer prevention and screening among African American women. Retrieved 8 25, 2016, from http://scholarworks.waldenu.edu/dissertations
Padilla CD, de la Paz EM (2012) Genetic services and testing in the Philippines. Journal of Community Genetics 4:399–411. https://doi.org/10.1007/s12687-012-0102-4
Pilarski R (2009) Risk perception among women at risk for hereditary breast and ovarian cancer. J Genet Couns 18:303–312. https://doi.org/10.1007/s10897-009-9227-y
Riley B, Culver J, Skrzynia C, Senter L, Peters J, Costalas J et al (2011) Essential elements of genetic cancer risk assessment, counseling and testing: updated recommendations of the National Society of Genetic Counselors. J Genet Couns 21:151–161. https://doi.org/10.1007/s10897-011-9462-x
Ryan G, Bernard H (2003) Techniques to identify themes. Field Methods 15(1):85–109. https://doi.org/10.1177/1525822x02239569
Schneider K (2012) Counseling about cancer: strategies for genetic counseling, 3rd edn. Wiley, Hoboken
Simpson J, Briggs K, George R (2015) Breast cancer amongst Filipino migrants: a review of the literature and ten-year institutional analysis. J Immigr Minor Health 17:729–736. https://doi.org/10.1007/s10903-015-0168-2
Spector D, Mishel M, Skinner CS, DeRoo L, VanRiper M, Sandler D (2009) Breast cancer risk perception and lifestyle behaviors among white and black women with a family history of the disease. Cancer Nurs 32(4):299–308. https://doi.org/10.1097/ncc.0b013e31819deab0
Subramanian P, Oranye NO, Masri AM, Taib AN, Ahmad N (2013) Breast cancer knowledge and screening behavior among women with a positive family hitsory: a cross sectional study. Asian Pac J Cancer Prev 14:6783–6790. https://doi.org/10.7314/apjcp.2013.14.11.6783
Trepanier A, Arhens M, McKinnon W, Peters J, Stopfer J, Grumet SC et al (2004) Genetic cancer risk assessment and counseling: recommendations of the National Society of Genetic Counselors. J Genet Couns 13:83–114. https://doi.org/10.1023/b:jogc.0000018821.48330.77
Underhill M, Lally R, Kiviniemi M, Murekeyisioni, Dickerson S (2012) Living my family's story: identifying the lived experiences in healthy women at risk for hereditary breast cancer. Cancer Nurs 35(6):493–504. https://doi.org/10.1097/ncc.0b013e31824530fa
Vetter L, Keller M, Bruckner T, Golatta M, Eismann S, Evers C et al (2016) Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening: a monocenter study in Germany. Breast Cancer Res Treat 156:289–299. https://doi.org/10.1007/s10549-016-3748-5
Wu T-Y, Bancroft J (2006) Filipino American women's perceptions and experiences with breast cancer screening. Oncol Nurs Forum 33:71–78. https://doi.org/10.1188/06.onf.e71-e78
Acknowledgments
We would like to thank the breast cancer patients and their sisters who willingly participated in this study.
Funding
This study was funded by the Department of Science and Technology-Accelerated Science and Technology Human Resource Development Program (DOST-ASTHRDP).
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John Benedict Lagarde, Mercy Laurino, Michael San Juan, Jaclyn Marie Cauyan, Ma-Am Joy Tumulak, and Elizabeth Ventura declare that they have no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
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No animal studies were carried out by the authors for this article.
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Lagarde, J.B.B., Laurino, M.Y., San Juan, M.D. et al. Risk perception and screening behavior of Filipino women at risk for breast cancer: implications for cancer genetic counseling. J Community Genet 10, 281–289 (2019). https://doi.org/10.1007/s12687-018-0391-3
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DOI: https://doi.org/10.1007/s12687-018-0391-3