French women’s breast self-examination practices with time after undergoing BRCA1/2 genetic testing

Abstract

To assess the impact of BRCA1/2 genetic test results on cancer-free women's breast-self-examination (BSE) practices and to prospectively determine their influence on psychological functioning. A prospective longitudinal study on French women's BSE practices and frequencies in BRCA1/2 carriers (N = 217) and non-carriers (N = 313) 1 and 2 years following disclosure of the test results, along with psychological factors predicting BSE practices. Before disclosure, BSE was practised by 47.2% of the women, and increased to 57.3% 1 year later. No change in the women's practices was noted between 12 and 24 months after the test. Carriers and non-carriers practicing regularly BSE at baseline were, respectively 8 to 6 times more likely to be practising BSE regularly at 12 months after being tested. Among the carriers, having fewer depressive symptoms at baseline and believing in the ability of BSE to detect breast cancer were found to be the most decisive factors associated with BSE practices 1 year after disclosure, following adjustment for BSE baseline practices. Among the non-carriers, believing in the ability of BSE to detect breast cancer, greater post-test anxiety, and a higher perceived risk of breast cancer were found to be predictors of post-test BSE practices after adjusting for BSE baseline practices. In France, where performing BSE is neither mandatory nor recommended, an increase in BSE practices was found to occur after disclosure of women's genetic test results, regardless of their carrier status.

What do women know about breast cancer prophylaxis and a healthy style of life?

“…It is worth emphasising that the increase of the frequency of performing self-examination after conducting the genetic test was not related to the level of education. 14 An attempt was made to show the correlation between the level of education and the effects of training in breast self-examination in a study involving 413 Turkish women aged 20-59. The results of the study showed that the Turkish women, regardless of the level of education, need support in this area -both informative and instrumental.…”

Uptake of genetic counseling among adult children of BRCA1/2 mutation carriers in France

“…In women, age has been shown to have a significant impact on cancer risk due to its association with risk‐reducing behaviors . Interventions to reduce cancer risk in mutation‐carrying patients include the following: earlier, more frequent, or more intensive cancer screening; risk‐reducing treatment; and risk‐reducing surgery, including bilateral mastectomy and salpingo‐oophorectomy . Men can also carry a BRCA1/2 mutation, but the implications for them are less clear because they appear to have different motivations for undergoing genetic counseling.…”

“…Our study is based on the French Gene Etude Prospective Sein Ovaire PsychoSocial (GENEPSO‐PS) cohort, which was derived from the GENEPSO cohort created in 2008 to identify the psychosocial characteristics and preventive behaviors of patients with a BRCA1/2 mutation . After 10 years of follow‐up, we decided to study the children of BRCA1/2 mutation carriers on the assumption that they have an increased risk of developing cancer and that they can therefore benefit from BRCA1/2 genetic testing .…”

Psychosocial problems in women attending French, German and Spanish genetics clinics before and after targeted or multigene testing results: an observational prospective study

“…Prolonged clinical distress is uncommon after single-gene testing for HBOC susceptibility 19. However, an inconclusive result such as a VUS may elicit misunderstanding,20 21 uncertainty21 22 and decisional conflicts about clinical management,23 potentially leading to increased distress,24 miscommunication between family members25 and inadequate cancer risk management decisions 21 26 27. On receiving a pathogenic moderate-penetrance gene variant, counselees may experience higher distress and uncertainty compared with a negative, VUS and even a pathogenic high-penetrance variant 28…”