A family history of breast cancer: women's experiences from a theoretical perspective

Rees, Gwyneth; Fry, Alison; Cull, Ann

doi:10.1016/s0277-9536(00)00248-3

Cited by 80 publications

(69 citation statements)

References 35 publications

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“…The results even suggest that the objective risk information provided in the counselling may be a relatively small event in this process of decision making. This fits recent acknowledgements that precounselling factors like past cancer stressors are important determinants for subsequent distress and behaviour (Zakowski et al, 1998;Baider et al, 1999;Erblich et al, 2000;Rees et al, 2001). The personal experience of the counsellee, including concomitant fears and emotional beliefs, is an essential element of the counselling interaction.…”

Section: Discussionsupporting

confidence: 80%

Genetic counselling and the intention to undergo prophylactic mastectomy: effects of a breast cancer risk assessment

et al. 2003

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Scientific reports suggest that women at risk for familial breast cancer may benefit from prophylactic mastectomy. However, few data are available about how women decide upon this clinical option, and in particular, what role an objective risk assessment plays in this. The purpose of the present study is to assess whether this objective risk information provided in genetic counselling affects the intention for prophylactic mastectomy. Additionally, the (mediating) effects of breast cancer worry and perceived risk are investigated. A total of 241 women completed a questionnaire before and after receiving information about their familial lifetime breast cancer risk in a genetic counselling session. Path analysis showed that the objective risk information had a corrective effect on perceived risk (b ¼ 0.38; P ¼ 0.0001), whereas the amount of breast cancer worry was not influenced by the counselling session. The objective risk information did not directly affect the intention for prophylactic mastectomy. The intention was influenced by perceived risk after counselling (b ¼ 0.23; P ¼ 0.002), and by the precounselling levels of perceived risk (b ¼ 0.27; P ¼ 0.00025) and breast cancer worry (b ¼ 0.32; P ¼ 0.0001), that is, higher levels of perceived risk and breast cancer worry imply a stronger intention for prophylactic mastectomy. A personal history of breast cancer did not directly influence the intention for prophylactic mastectomy, but affected women who had undergone a mastectomy as surgical treatment were more positively inclined to have a prophylactic mastectomy than women who had had breast-conserving therapy. The impact of objective risk information on the intention for prophylactic mastectomy is limited and is mediated by perceived risk. Important determinants of the intention for prophylactic mastectomy were precounselling levels of breast cancer worry and perceived risk, suggesting that genetic counselling is only one event in the entire process of decision making. Therefore, interventions aimed at improving decision making on prophylactic mastectomy should explicitly address precounselling factors, such as personal beliefs and the psychological impact of the family medical history.

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Section: Discussionsupporting

confidence: 80%

Genetic counselling and the intention to undergo prophylactic mastectomy: effects of a breast cancer risk assessment

et al. 2003

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“…Their perceived vulnerability may be based on the burden of cancer in the family rather than on the hereditary nature of a faulty gene or a family history. Other studies also reported this factor as an important triggering factor in considering personal risk and vulnerability (Evans et al 1993;McAlister 2003;Rees et al 2001;Walter and Emery 2005). Individuals' perceived vulnerability to a familial condition was defined and heightened by their experience of going through the illness with their affected relatives, and/or demise of their close ones.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have explored the process and events that influenced the development of a personal perception of risk (Evans et al 1993;Pilarski 2009;Rees et al 2001). Some studies also explored lay understanding of familial risk of cancer and found that individuals' perceived risk and/or vulnerability was based on the burden of disease, i.e.…”

Section: Literature Reviewmentioning

confidence: 99%

Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care

et al. 2011

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Patient self-initiated consultations to discuss family history of cancer in primary care and the factors leading to these consultations have not been investigated. Seventy-one out of 150 asymptomatic patients with a family history of cancer at the Yorkshire Cancer Genetics Service participated in this study. A semi-structured questionnaire was administered. The results show that (1) family cancer events, doctors' advice and reaching the age of cancer-affected relatives were more salient in raising awareness of the added cancer risk due to family history than media and publicity, and knowledge of the genetics services; (2) knowledge of family medical history and its clinical value is not easy to ascertain; (3) the interrelationships with other causal beliefs are of interest and could provide insights to understand the factors motivating patients to discuss family history or cancer risk; (4) the belief that 'cancer runs in the family' or is 'a family thing' may not be sufficient to heighten perceived cancer risk and motivate patients to seek medical advice; and (5) understanding of the medical concept and clinical value of family history is poor even in this group of patients who initiated the GP consultations. In conclusion, because most primary care practitioners are likely to rely on patient initiated discussion to identify individuals at an increased risk of cancer because of their family history, these findings are therefore important to help doctors and health providers understand the reasons influencing asymptomatic patients to self-refer themselves in primary care and discuss cancer risk in order to provide appropriate care.

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“…In addition, survivors' attributions may influence cancer prevention attitudes and behaviors among those in direct contact with them [16]. Etiological attributions and consequent response to cancer risk by female relatives are influenced by the subjective experience of breast cancer in the family [25,26].…”

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confidence: 99%

What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors

Dumalaon-Canaria

Hutchinson

Prichard

et al. 2014

Cancer Causes Control

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What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert endorsed risks'. Cancer Causes and Control, vol 25 (7) 2014, pp. 771-785. Copyright (2014) Springer International PublishingSwitzerland. All rights reserved. Please note that any alterations made during the publishing process may not appear in this version.The final publication is available at Springer via http:// dx.doi.org/10.1007/s10552-014-0377-3. psychological. Lifestyle-related attributions such as physical inactivity were coded as internal to the individual and modifiable. By contrast, environmental attributions such as air pollution and occupational hazards were considered external to the individual and fixed or non-modifiable. These characteristics tended to correlate so that internal and unstable attributions such as lifestyle-related factors were considered controllable whereas external attributions were likely to stem from the environment and exhibited lower controllability.Although causal attributions alone will not predict patients' behaviors and explain the complexity of human actions, attribution theory provides a framework for understanding the cognitions that influence healthrelated behaviors. Beliefs that people hold with regards to the cause of their own illness influence their decision to seek help, to adhere to medical treatment and their psychological adjustment, during and after treatment [6,10]. Attribution theory also helps explain affective responses to cancer and ways of coping. In the broader population, the media is another factor that shapes understandings of breast cancer causation among women. For example, media coverage of celebrity diagnoses of breast cancer in young women may have led to underestimation of age as a risk factor [27]. Similarly, reports focused on personal accounts of affected women with a family history of breast cancer may have influenced views that breast cancer is a predominantly genetic disease [28]. Social media, particularly blog posts and discussion posts shared by breast cancer patients themselves, has also become an influential and credible forum for the promulgation of health information [29].The following systematic review serves to comprehensively summarize literature on beliefs that affected women have about the cause of their own breast cancer and contrasts this with expert consensus derived from meta-analyses of various risk factors for breast cancer. Findings of this study may inform psychoeducational interventions which can help affected women develop accurate and adaptive beliefs about the cause of their breast cancer. Methodology Data SourcesThe following PubMed, PsycINFO and Web of Knowledge search was conducted on January 25, 2013:(breast cancer OR breast neoplasm) AND (caus* 1 OR attribute* OR belie* OR attitude OR illness 1 *Search term and its derivatives were used (e.g., cause, causes, causal) Inclusion/Exclusion CriteriaStudies were included in the review if they reported causal attributions or beliefs of...

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A family history of breast cancer: women's experiences from a theoretical perspective

Cited by 80 publications

References 35 publications

Genetic counselling and the intention to undergo prophylactic mastectomy: effects of a breast cancer risk assessment

Genetic counselling and the intention to undergo prophylactic mastectomy: effects of a breast cancer risk assessment

Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care

What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors

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