Psychological impact of recall in high-risk breast MRI screening

O'Neill, Suzanne M.; Rubinstein, Wendy S.; Sener, Stephen F.; Weissman, Scott M.; Newlin, Anna; West, Daniel K.; Ecanow, David B.; Rademaker, Alfred; Edelman, Robert R.

doi:10.1007/s10549-008-0140-0

Cited by 19 publications

(18 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another study found increased avoidance scores after abnormal MRI results A c c e p t e d M a n u s c r i p t 14 compared to baseline levels (IES avoidance subscale from 6.5 (SD 7.6) to 9.5 (SD 8.4)), but this was found to be related to the overrepresentation of BRCA mutation carriers in this group rather than to MRI results. BRCA mutation carriers had ashowed greater increase of distress scores between a first and second MRI versus BRCA negative or untested subjects (IES increase of 11.6 versus decrease of 0.86 points) and carrying a BRCA mutation was the only predictor for increased distress levels [41].…”

Section: Psychological Distress: Anxiety Depression and Cancer Worrymentioning

confidence: 91%

“…All studies were prospective, included 55 to 357 women at high risk for breast and ovarian cancer, and the absolute number of BRCA mutation carriers varied from 17 to 55 women. Only Tthree studies only concerned were limited to unaffected women [39,40], while 3% and 58% of the participants had a personal history of breast or ovarian cancer in the other two [41,42]. Authors used different questionnaires at different time points, but at least before a surveillance visit and 1 month until 5-8 years thereafter.…”

Section: Page 13 Of 91mentioning

confidence: 99%

“…We identified five relevant articles about the influence of surveillance for breast cancer on QoL or related items [39][40][41][42][43]. There were no randomized controlled trials in literature.…”

Section: Surveillancementioning

confidence: 99%

See 2 more Smart Citations

How medical choices influence quality of life of women carrying a BRCA mutation

Harmsen

Hermens

Prins³

et al. 2015

Critical Reviews in Oncology/Hematology

View full text Add to dashboard Cite

Section: Psychological Distress: Anxiety Depression and Cancer Worrymentioning

confidence: 91%

Section: Page 13 Of 91mentioning

confidence: 99%

See 1 more Smart Citation

How medical choices influence quality of life of women carrying a BRCA mutation

Harmsen

Hermens

Prins³

et al. 2015

Critical Reviews in Oncology/Hematology

View full text Add to dashboard Cite

“…The challenges associated with interpreting/counseling patients about VUSs with single-gene testing are well recognized (Petrucelli et al, 2002;Meiser, 2005;Patenaude et al, 2006;Vos et al, 2008Vos et al, , 2011Cypowyj et al, 2009;O'Neill et al, 2009;Murray et al, 2011;Culver et al, 2013). Self-confidence about single-gene VUS counseling in this study was high, likely because CCGCoP members have GCRA training and access to case-based support.…”

mentioning

confidence: 86%

Next-Generation Testing for Cancer Risk: Perceptions, Experiences, and Needs Among Early Adopters in Community Healthcare Settings

Blazer

Nehoray

Solomon

et al. 2015

Genetic Testing and Molecular Biomarkers

View full text Add to dashboard Cite

Background: Advances in next-generation sequencing (NGS) technologies are driving a shift from single-gene to multigene panel testing for clinical genetic cancer risk assessment (GCRA). This study explored perceptions, experiences, and challenges with NGS testing for GCRA among U.S. community-based clinicians. Methods: Surveys delivered at initial and 8-month time points, and 12-month tracking of cases presented in a multidisciplinary web-based case conference series, were conducted with GCRA providers who participated in a 235-member nationwide community of practice. Results: The proportion of respondents ordering panel tests rose from 29% at initial survey (27/94) to 44% (46/107) within 8 months. Respondents reported significantly less confidence about interpreting and counseling about NGS compared with single-gene test results ( p < 0.0001 for all comparisons). The most cited reasons for not ordering NGS tests included concerns about clinical utility, interpreting and communicating results, and lack of knowledge/skills. Multigene panels were used in 204/668 cases presented during 2013, yielding 37 (18%) deleterious (7% in low/moderate-penetrance genes), 88 (43%) with ‡1 variant of uncertain significance, 77 (38%) uninformative negative, and 2 (1%) inconclusive results. Conclusions: Despite concerns about utility and ability to interpret/counsel about NGS results, a rapidly increasing uptake of NGS testing among community clinicians was documented. Challenges identified in case discussions point to the need for ongoing education, practice-based support, and opportunities to partner in research that contributes to characterization of lesser known genes.

show abstract

“…Furthermore, the relatively high-recall rates for breast MRI have posed concerns about quality of life. In general, psychological disturbance seems not to be a crucial factor for the high-risk screening population, 61 even for those undergoing screening recall events, 64 but vulnerable subgroups may exist. Overall, the lack of clear parameters needed to model life expectancy and costs impedes the development of a more comprehensive decision analysis.…”

Section: Limitationsmentioning

confidence: 99%

Cost-effectiveness of population-based BRCA1/2 testing and ovarian cancer prevention for Ashkenazi Jews: A call for dialogue

Rubinstein

Jiang

Dellefave

et al. 2009

Genetics in Medicine

Self Cite

View full text Add to dashboard Cite

Purpose: About half of unaffected BRCA1/2 carriers have a negative family history, confounding efforts toward presymptomatic carrier identification. Ovarian cancer is preventable for known carriers but is otherwise highly lethal. Cost-effectiveness and gains in life expectancy are important factors in evaluating the desirability of population-based genetic screening, currently the only viable strategy to identify carriers with unrevealing family histories. Methods: Cost-utility analysis for a population-based genetic screening program offered to American Ashkenazi Jewish women aged 35-55 years measuring cancer incidence, life expectancy, and cost. Results: Our model predicts that a genetic screening program would result in 2811 fewer cases of ovarian cancer, with a life expectancy gain of 1.83 quality-adjusted life years among carriers. At a cost of $460 for founder mutation testing, the cost of the program is $8300 (discounted) per year of quality-adjusted life gained. Conclusion:In populations with a high prevalence of BRCA1/2 founder mutations, genetic screening may be cost-effective when compared with recommended public health interventions such as mammographic screening. We advocate the initiation of a dialogue among Jewish stakeholders, genetics professionals, and public health leaders to determine whether a population-based BRCA1/2 genetic screening program should be pursued. Genet Med 2009:11(9):629 -639. Key Words: BRCA1, BRCA2, decision analysis, ovarian carcinoma, population-based genetic screeningA n inherited predisposition to hereditary breast and ovarian cancer should be heralded by a strong cancer family history, but surprisingly often, it is not. Incomplete penetrance, sexlimited expression, limited family structure, and incomplete family history information all contribute to the frequent observation of hereditary cancer cases, which lack premonitory clues. Female BRCA1/2 carriers who are unaware of their genetic status cannot undertake recommended measures such as early mammography and breast magnetic resonance imaging (MRI) or avail themselves of risk-reducing salpingo-oophorectomy after completion of childbearing. Women with nonscreen detected, early-onset breast cancer and those who develop ovarian cancer can be expected to face much higher morbidity and mortality than if they were undergoing high-risk management.An underlying assumption in clinical cancer genetics is that by maximizing the efficiency of the referral pipeline through such means as physician and patient education and computerized family history tools, most unaffected BRCA1/2 carriers could be identified before developing cancer. High-risk management could then be instituted in a family-centered manner to reduce the cancer burden. Although this holds true for families with recognizable features of hereditary cancer, several studies suggest that about half of all BRCA1/2 families cannot be identified using this approach. [1][2][3][4][5][6][7][8] BRCA1/2 mutation prevalence rates have been measured in several population-based...

show abstract

Psychological impact of recall in high-risk breast MRI screening

Abstract: Practitioners' concerns about the high false positive rate of breast MRI may not be matched by actual psychological effects in most high-risk women.

Cited by 19 publications

References 33 publications

How medical choices influence quality of life of women carrying a BRCA mutation

How medical choices influence quality of life of women carrying a BRCA mutation

Next-Generation Testing for Cancer Risk: Perceptions, Experiences, and Needs Among Early Adopters in Community Healthcare Settings

Cost-effectiveness of population-based BRCA1/2 testing and ovarian cancer prevention for Ashkenazi Jews: A call for dialogue

Contact Info

Product

Resources

About