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Journal of Genetic Counseling

, Volume 13, Issue 3, pp 237–257 | Cite as

The Decision to Test in Women Receiving Genetic Counseling for BRCA1 and BRCA2 Mutations

  • Kimberly Kelly
  • Howard Leventhal
  • Michael Andrykowski
  • Deborah Toppmeyer
  • Judie Much
  • James Dermody
  • Monica Marvin
  • Jill Baran
  • Marvin Schwalb
Article

Abstract

Functions of genetic counseling include provision of risk information and provision of support in an effort to assist with decision making. This study examines (1) the relationship among intentions to test, self-reported provision of blood sample, and receipt of test results; (2) the impact of genetic counseling on distress specific to gene status, perceived risk of developing breast and ovarian cancer in the context having BRCA1/2 mutations (mutations predisposing to increased risk of breast–ovarian cancer), and perceived risk factors for breast cancer; and (3) the clinical profile of those receiving/not receiving results. Intentions to test for BRCA1/2 mutations, self-reported provision of blood sample immediately after counseling, and receipt of test results were statistically different but highly correlated, and intentions to test increased from pre- to postcounseling. A repeated measures ANOVA found distress specific to gene status and perceived risk factors decreased from pre- to postcounseling. Further, two clinical profiles of consultands emerged: (1) those receiving results with change in intentions to test having lower levels of distress and (2) those not receiving results and those receiving results with no change in intentions to test with higher levels of distress. Our findings are consistent with the function of genetic counseling—to provide information and support to those with familial cancer, as well as to assist in decision making. The provision of support is important as distress specific to gene status may impede flexible decision making about genetic testing.

BRCA1/2 testing genetic testing breast cancer ovarian cancer genetic counseling risk perception psychosocial factors 

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Copyright information

© National Society of Genetic Counselors, Inc. 2004

Authors and Affiliations

  • Kimberly Kelly
    • 1
  • Howard Leventhal
    • 2
  • Michael Andrykowski
    • 1
  • Deborah Toppmeyer
    • 3
  • Judie Much
    • 3
  • James Dermody
    • 4
  • Monica Marvin
    • 5
  • Jill Baran
    • 3
  • Marvin Schwalb
    • 4
  1. 1.Department of Behavioral ScienceUniversity of KentuckyLexington
  2. 2.Institute for Health, Health Care Policy, and Aging ResearchRutgers UniversityNew Brunswick
  3. 3.LIFE Center – Cancer Risk Assessment and Genetic Counseling Program – Breast OncologyCancer Institute of New JerseyNew Brunswick
  4. 4.Center for Human and Molecular Genetics, University of Medicine and Dentistry of New JerseyThe New Jersey Medical SchoolNewark
  5. 5.Spectrum HealthGrand Rapids

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