Women’s concerns about the emotional impact of awareness of heritable breast cancer risk and its implications for their children

Abstract

Women tested for mutations in BRCA1/2 genes who have minor-aged children confront difficult decisions about if, when, and how to share information about hereditary cancer risk with their children. These choices are often seemingly influenced by how mothers anticipate the emotional burdens they and their children will experience in response to test results. Here, we investigate the association between maternal cognitions, pretest psychological well-being, and coping style with mothers' anticipated emotional reactions to learning that they are BRCA1/2 mutation carriers (N=205). In a linear regression model adjusted for maternal demographics, stronger tendencies to ruminate about information (B=.14, p=.03), greater psychological strain (B=.14, p<.001), and poorer appraisals of one's ability to cope with genetic test results conveying increased breast cancer risk information (B=−.25, p<.001) were significantly associated with anticipating more negative affect surrounding BRCA1/2 mutation identification in mothers. Our data contribute to the growing awareness of special concerns that mothers have about knowing their BRCA1/2 mutation status and highlight the need for more tailored patient education and counseling resources to improve outcomes among women at risk and their children.

Familial breast cancer: Genetic counseling over time, including patients´ expectations and initiators considering the Angelina Jolie effect

“…These topics need to be addressed during consultation to meet those demands and outline the limits of current knowledge. Women with children, especially younger daughters, are found to have more concerns and therefore are more likely to attend a consultation [ 40 ]. Psychosomatic programs might be effective in improving quality of life and reducing distress and worries among these subgroups.…”

Maternal perceptions of BRCA genetic counseling communication processes about disclosing cancer risk information to children and adult relatives

“…Complete details are provided elsewhere . Briefly, participants at 2 NCI‐designated comprehensive cancer centers were approached for trial enrollment at the time of their BRCA pretest education and comprehensive genetic counseling session and after providing a DNA sample for BRCA testing.…”

“…Complete details are provided elsewhere. 20 Briefly, participants at 2 NCI-designated comprehensive cancer centers were approached for trial enrollment at the time of their BRCA pretest education and comprehensive genetic counseling session and after providing a DNA sample for BRCA testing. Data for the present analysis were collected during a telephone interview conducted 30 days following the post-test genetic counseling and result disclosure session (as per standard of care, 2,21 topics potentially covered in this session include test result interpretation, medical management and follow-up, psychosocial care, and family communication.…”

Development of decision aids for female BRCA1 and BRCA2 mutation carriers in Germany to support preference-sensitive decision-making

“…To foster high quality decision-making in such situations, it is important, to provide women with sufficient evidence-based medical information that enables them to get a realistic picture of their risk constellations and their options [ 25 ]. On the other hand, it is also important to take into account personal factors such as their individual life situation, family and psychological stressors, as well as their individual values and preferences [ 19 , 25 – 27 ].…”