At-Risk Women Want Breast Cancer Gene Test--If 'Pros' Outweigh 'Cons'

September 23, 1997

Women who have a family history of breast cancer want to be tested to learn if they have inherited a genetic mutation that predisposes them to the disease -- but only if they believe the benefits of such knowledge outweigh the disadvantages.

A research team at the H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida, and Memorial Sloan-Kettering Cancer Center in New York asked 74 women who had close relatives with breast cancer if they were prepared to undergo genetic testing for BCRA1 and BCRA2, the genetic mutations associated with breast cancer. The women were also asked about their perceptions of the pros and cons of such testing.

The researchers report in the September-October issue of Psychosomatic Medicine that 81 percent of the women planned to seek genetic testing, and 46 percent said they were interested in getting tested as soon as possible. For most of them, the readiness to be tested was strongly related to their perceptions that the advantages outweighed the disadvantages.

"Genetic testing provides powerful information and, as this study shows, a woman's desire to be tested hinges largely on her perception that there is more to be gained than lost by having this knowledge," said Paul Jacobsen, PhD, lead author of the study. "These findings underscore the importance of providing counseling to women who plan to undergo genetic testing for breast cancer susceptibility."

Jacobsen, a psychologist at the Moffitt Cancer Center and the University of South Florida, said counseling is needed to help women know how to use their newfound knowledge to their advantage, as well as to prevent adverse psychological reactions and to assist them in evaluating treatment options.

In the study, a majority of women reported that learning about their genetic risk would motivate them to practice breast self-examination more frequently, and help them decide whether to go for more frequent mammograms or undergo preventive surgery.

As scientists identify an increasing number of mutant genes associated with diseases, public debate has focused on fears that employers and insurers might use the results of such tests to discriminate against those who carry the mutant genes. Despite this, most women in the study perceived relatively few disadvantages from genetic testing.

As might be expected, their concerns were related primarily to the possibility of learning they had inherited a susceptibility to breast cancer. In that event, most said they would worry more than they do now about developing breast cancer themselves and about other family members who may also have the gene. About 5 to 10 percent of all breast cancers are attributed to an inherited genetic risk, and women who inherit these genetic mutations have up to a 90 percent chance of developing breast cancer during their lifetime.

The study was funded by the T.J. Martell Foundation, the American Cancer Society and the U.S. Department of the Army.

To contact Dr. Jacobsen, call (813) 979-3862.

Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bi-monthly. For information about the journal, contact Joel E. Dimsdale, MD, editor-in-chief: (619) 543-5468.

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Contact: Richard Hébert, (202) 387-2829;
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