Skip to main content
SpringerLink
Log in

Cancer Genetics Service Interest in Women with a Limited Family History of Breast Cancer

  • Original Research
  • Published:
Journal of Genetic Counseling

Abstract

Women with a limited family history of breast cancer may be interested in cancer genetics information although their objective risk of breast cancer may not indicate routine referral to cancer genetics services. This study examined factors related to interest and use of cancer genetics services in a community sample of women with a limited family history of breast cancer (N = 187) who had no previous contact with cancer genetics services. Participants provided demographic information and ratings of perceived risk, cancer distress, attitudes, and intentions to initiate cancer genetics services. Participants were given information about a cancer genetics clinic that served women having concerns about their breast cancer risk. Women were contacted within 6 weeks and 8 months following their study appointment. Six weeks following their study appointment, 25% of women had initiated cancer genetics services. Eight months following their study appointment, 18% of women reported having completed a cancer genetics service appointment. Baseline intentions independently predicted both initiation at 6 weeks and appointment at 8 months. Cancer distress was positively associated with cancer genetics service initiation and appointment. Results suggest that some women with a limited family history of breast cancer are interested in seeking out cancer genetics information. Women with a limited family history of breast cancer may benefit from the availability of cancer genetics information provided through primary healthcare settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. Significant family history is defined as for non-Askenazi Jewish women having two first-degree relatives with breast cancer, one of who received the diagnosis before or at age 50; a combination of three or more first- or second degree relatives with breast cancer regardless of age at diagnosis; a combination of both breast and ovarian cancer among first- and second- degree relatives; a first-degree relative with bilateral breast cancer; a first- or second-degree relative with both breast and ovarian cancer at any age; history of breast cancer in a male relative.

  2. The discrepancy between the year of publication of this manuscript and the year of study initiation (2006 vs. 2005) is due to the cited manuscript being in preparation when the study began.

  3. The discrepancy between the year of publication of this manuscript and the year of study initiation (2007 vs. 2005) is due to the cited manuscript being in preparation when the study began.

  4. Women recruited through the research registry (n = 25) were not statistically distinct on any study variables when compared to women recruited through community advertisement with the exception of age (M[SD] = 50.6[8.3] vs. 40.5[12.0]; p < .001) and objective risk (M[SD] = 2.2[1.1] vs. 1.2[1.1]; p < .001).

References

  • Amir, E., Evans, D. G., Shenton, A., Lalloo, F., Moran, A., Boggis, C., Wilson, M., et al. (2003). Evaluation of breast cancer risk assessment packages in the family history evaluation and screening programme. Journal of Medical Genetics, 40, 807–814.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • American Cancer Society. (2007). Cancer facts and figures. Atlanta: American Cancer Society.

    Google Scholar 

  • Barlow, W. E., White, E., Ballard-Barbash, R., Vacek, P. M., Titus-Ernstoff, L., Carney, P. A., Tice, J. A., et al. (2006). Prospective breast cancer risk prediction model for women undergoing screening mammography. Journal of the National Cancer Institute, 98, 1204–1214.

    Article  PubMed  Google Scholar 

  • Bishop, A. J., Marteau, T. M., Hall, S., Kitchener, H., & Hajek, P. (2005). Increasing women’s intentions to stop smoking following an abnormal cervical smear test. Preventive Medicine, 41, 179–185.

    Article  PubMed  Google Scholar 

  • Bober, S. L., Hoke, L. A., Duda, R. B., Regan, M. M., & Tung, N. M. (2004). Decision-making about tamoxifen in women at high risk for breast cancer: Clinical and psychological factors. Journal of Clinical Oncology, 22, 4951–4957.

    Article  PubMed  Google Scholar 

  • Bowen, D., McTiernan, A., Burke, W., Powers, D., Pruski, J., Durfy, S., Gralow, J., et al. (1999). Participation in breast cancer risk counseling among women with a family history. Cancer Epidemiology Biomarkers and Prevention, 8, 581–585.

    CAS  Google Scholar 

  • Bowen, D. J., Helms, A., Powers, D., Andersen, R., Burke, W., McTiernan, A., et al. (2003). Predicting breast cancer screening intentions and behavior with emotion and cognition. Journal of Social and Clinical Psychology, 22, 213–232.

    Article  Google Scholar 

  • Bowen, D. J., Alfano, C. M., McGregor, B. A., & Andersen, M. R. (2004). The relationship between perceived risk, affect and health behaviors. Cancer Detection and Prevention, 28, 409–417.

    Article  PubMed  Google Scholar 

  • Burke, W., & Emery, J. (2002). Genetics education for primary-care providers. Nature, 3, 561–566.

    CAS  Google Scholar 

  • Burke, W., Culver, J. O., Bowen, D., Lowry, D., Durfy, S., McTiernan, A., & Andersen, M. R. (2000). Genetic counseling for women with an intermediate family history of breast cancer. American Journal of Medical Genetics, 90, 361–368.

    Article  CAS  PubMed  Google Scholar 

  • Cameron, L. D., & Reeve, J. (2006). Risk perceptions, worry, and attitudes about genetic testing for breast cancer susceptibility. Psychology and Health, 21, 211–230.

    Article  PubMed  Google Scholar 

  • Cappelli, M., Surh, L., Walker, M., Korneluk, Y., Humphreys, L., Verma, S., et al. (2001). Psychological and social predictors of decisions about genetic testing for breast cancer in high-risk women. Psychology Health and Medicine, 6, 321–333.

    Article  Google Scholar 

  • Chaliki, H., Loader, S., Levenkron, J. C., Logan-Young, W., Hall, W. J., & Rowley, P. T. (1995). Women’s receptivity to testing for a genetic susceptibility to breast cancer. American Journal of Public Health, 85, 1133–1135.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Clark, V. A., Lovegrove, H., Williams, A., & Machperson, M. (2000). Unrealistic optimism and the health belief model. Journal of Behavioral Medicine, 23, 367–376.

    Article  Google Scholar 

  • Claus, E. B., Risch, N., & Thompson, W. D. (1994). Autosomal dominant inheritance of early-onset breast cancer: Implications for risk prediction. Cancer, 73, 643–651.

    Article  CAS  PubMed  Google Scholar 

  • Colditz, G. A., Willet, W. C., Hunter, D. J., Stampfer, M. J., Manson, J. E., Hennekens, C. H., & Rosner, B. A. (1993). Family history, age, and risk of breast cancer. Prospective data from the Nurses’ Health Study. Journal of the American Medical Association, 270, 338–343.

    Article  CAS  PubMed  Google Scholar 

  • Collaborative Group on Hormonal Factors in Breast Cancer (2001). Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 28,209 women with breast cancer and 101,986 women without the disease. Lancet, 358, 1389–1399.

    Article  Google Scholar 

  • Culver, J., Burke, W., Yasui, Y., Durfy, S., & Press, N. (2001). Participation in breast cancer genetic counseling: The influence of educational level, ethnic background, and risk perception. Journal of Genetic Counseling, 10, 215–231.

    Article  Google Scholar 

  • DiMatteo, M. R., Sherbourne, C. D., Hays, R. D., Ordway, L., Kravitz, R. L., McGlynn, E. A., Kaplan, S., et al. (1993). Physicians’ characteristics influence patients’ adherence to medical treatment: results from the Medical Outcomes Study. Health Psychology, 12, 91–92.

    Article  Google Scholar 

  • Doukas, D. J., & Localio, A. R. (2004). Attitudes and beliefs concerning prostate cancer genetic screeing. Clinical Genetics, 66, 445–451.

    Article  PubMed  Google Scholar 

  • Erblich, J., Bovbjerg, D. H., & Valdimarsdottir, H. B. (2000). Looking forward and back: Distress among women at familial risk for breast cancer. Annals of Behavioral Medicine, 22, 53–59.

    Article  CAS  PubMed  Google Scholar 

  • Euhus, D. M. (2001). Understanding mathematical models for breast cancer risk assessment and counseling. Breast Journal, 7, 224–232.

    Article  CAS  PubMed  Google Scholar 

  • Euhus, D. M., Leitch, A. M., Huth, J. F., & Peters, G. N. (2002). Limitations of the gail model in the specialized breast cancer risk assessment clinic. Breast Journal, 8, 23–27.

    Article  PubMed  Google Scholar 

  • Fisher, B., Costantino, J. P., Wickerham, L., Redman, C. K., Kavanah, M., Cronin, W. M., Vogel, V., et al. (1998). Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. Journal of the National Cancer Institute, 90, 1371–1388.

    Article  CAS  PubMed  Google Scholar 

  • Fisher, B., Costantino, J. P., Wickerham, L., Cecchini, R. S., Cronin, W. M., Robidoux, A., Beyers, T. B., et al. (2005). Tamoxifen for the prevention of breast cancer: current status of the national surgical breast and bowel project P-1 study. Journal of the National Cancer Institute, 97, 1652–1662.

    Article  CAS  PubMed  Google Scholar 

  • Fraser, F. C. (1974). Genetic counseling. American Journal of Human Genetics, 26, 636–661.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gail, M. H., Brinton, L. A., Byar, D. P., Corle, D. K., Green, S. B., Schairer, C., & Mulvihill, J. J. (1989). Projecting individualized probabilities of developing breast cancer for white females who are examined annually. Journal of the National Cancer Institute, 81, 1879–1886.

    Article  CAS  PubMed  Google Scholar 

  • Green, M. J., Peterson, S. K., Baker, M. W., Harper, G. R., Friedman, L. C., Rubinstein, W. S., & Mauger, D. T. (2004). Journal of the American Medical Association, 292, 442–452.

    Article  CAS  PubMed  Google Scholar 

  • Kaplan, C. P., Hass, J. S., Perez-Stable, E. J., Gregorich, S. E., Somkin, C., Des Jarlais, G., & Kerlikowske, K. (2006). Breast cancer risk reduction options: Awareness, discussion, and use among women from four ethnic groups. Cancer Epidemiology Biomarkers and Prevention, 15, 162–166.

    Article  Google Scholar 

  • Kerlikowske, K., Carney, P. A., Geller, B., Mandelson, M. T., Taplin, S. H., Malvin, K., Ernster, V., et al. (2000). Performance of screening mammography among women with and without a first-degree relative with breast cancer. Annals of Internal Medicine, 133, 855–863.

    Article  CAS  PubMed  Google Scholar 

  • Lee, S. C., Bernhardt, B. A., & Helzlsouer, K. J. (2002). Utilization of BRCA1/2 genetic testing in the clinical setting: report from a single institution. Cancer, 94, 1876–1885.

    Article  PubMed  Google Scholar 

  • Lerman, C., Kash, K., & Stefanek, M. (1994). Younger women at increased risk for breast cancer: perceived risk, psychological well-being, and surveillance behavior. Journal of the National Cancer Institute Monographs, 16, 171–176.

    Google Scholar 

  • Lerman, C., Lustbader, E., Rimer, B., Daly, M., Miller, S., Sands, C., & Balshem, A. (1995). Effects of individualized breast cancer risk counseling: a randomized trial. Journal of the National Cancer Institute, 87, 286–292.

    Article  CAS  PubMed  Google Scholar 

  • Leventhal, H., & Cameron, L. (1987). Behavioral theories and the problem of compliance. Patient Education and Counseling, 10, 117–138.

    Article  Google Scholar 

  • Lipkus, I. M., Klein, W. M. P., Skinner, C. S., & Rimer, B. (2005). Breast cancer risk perceptions and breast cancer worry: What predicts what? Journal of Risk Research, 8, 439–452.

    Article  Google Scholar 

  • McAuley, E., Motl, R. W., Morris, K. S., Hu, L., Doerksen, S. E., Elavsky, S., et al. (2007). Enhancing physical activity adherence and well-being in multiple sclerosis: a randomized controlled trial. Multiple Sclerosis, 13, 652–659.

    Article  CAS  PubMed  Google Scholar 

  • McTiernan, A., Kuniyuki, A., Yasuim, Y., Bowen, D., Burke, W., Culver, J. B., Anderson, R., et al. (2001). Comparisons of two breast cancer risk estimates in women with a family history of breast cancer. Epidemiology Biomarkers Prevevention, 10, 333–338.

    CAS  Google Scholar 

  • O’Neill, S. M., Peters, J. A., Vogel, V. G., Feingold, E., & Rubinstein, W. S. (2006). Referral to cancer genetic counseling: Are there stages of readiness? American Journal of Medical Genetics Part C, Seminars in Medical Genetics, 142, 221–231.

    Article  Google Scholar 

  • Palmero, E. I., Kalakun, L., Schuler-Faccini, L., Giugliani, R., Regla Vargas, F., Rocha, J. C. & Ashton-Prolla, P. (2007). Cancer genetic counseling in public health care hospitals: The experience of three Brazilian services. Community Genetics, 10, 110–119.

    PubMed  Google Scholar 

  • Press, N. A., Yasui, Y., Reynolds, S., Durfy, S. J. & Burke, W. (2001). Women’s interest in genetic testing for breast cancer susceptibility may be based on unrealistic expectations. American Journal of Medical Genetics, 10, 99–110.

    Article  Google Scholar 

  • Rahm, A. K., Sukhanova, A., Ellis, J., & Mouchawar, J. (2007). Increasing utilization of cancer genetic counseling services using a patient navigator model. Journal of Genetic Counseling, 16, 171–177.

    Article  PubMed  Google Scholar 

  • Robinson, J. K., Turrisi, R., & Stapleton, J. (2007). Examination of mediating variables in a partner assistance intervention designed to increase performance of skin self-examination. Journal of the American Academy of Dertmatology, 56, 391–397.

    Article  Google Scholar 

  • Thompson, H. S., Valdimarsdottir, H. B., Duteau-Buck, C., Guevarra, J., Bovbjerg, D. H., Richmond-Avellaneda, , Godfrey, A., et al. (2002). Psychosocial predictors of BRCA counseling and testing decisions among urban African-American women. Cancer Epidemiology, Biomarkers & Prevention, 11, 1579–1585.

    Google Scholar 

  • Tice, J. A., Miike, R., Adduci, K., Petrakis, N. L., King, E., & Wrensch, M. R. (2005). Nipple aspirate fluid cytology and the gail model for breast cancer risk assessment in a screening population. Cancer Epidemiology, Biomarkers and Prevention, 14, 324–328.

    Article  PubMed  Google Scholar 

  • Tyrer, J., Duffy, S. W., & Cuzick, J. (2004). A breast cancer prediction model incorporating familial and personal risk factors. Statistics in Medicine, 23, 1111–1130.

    Article  PubMed  Google Scholar 

  • U.S. Preventive Services Task Force. (2005). Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility: Recommendation statement. Annals of Internal Medicine, 143, 355–361.

    Article  Google Scholar 

  • Watson, E. K., Shickle, D., Qureshi, N., Emery, J., & Austoker, J. (1999). The ‘new genetics’ and primary care: GPs’ views on their role and their educational needs. Family Practice, 16, 420–425.

    Article  CAS  PubMed  Google Scholar 

  • Weinstein, N. D., & Klein, W. M. (1995). Resistance of personal risk perceptions to debiasing interventions. Health Psychology, 2, 132–140.

    Article  Google Scholar 

  • Weinstein, N. D., Kwitel, A., McCaul, K. D., Magnan, R. E., Gerrard, M., & Gibbons, F. X. (2007). Risk perceptions: assessment and relationship to influenza vaccination. Health Psychology, 26, 146–151.

    Article  PubMed  Google Scholar 

  • Weiss, D., & Marmar, C. (1997). The Impact of Event Scale-Revised. In J. Wilson, & T. Keane (Eds.), Assessing psychological trauma and PTSD. Guildford: New York.

    Google Scholar 

  • Zajac, L. E., Klein, W. M., & McCaul, K. D. (2006). Absolute and comparative risk perceptions as predictors of cancer worry: Moderating effects of gender and psychological distress. Journal of Health Communication, 11, S37–S49.

    Article  Google Scholar 

Download references

Acknowledgements

Portions of this article were presented at the 2007 Society of Behavioral Medicine Annual Conference in Washington, DC. Author AB is now at the University of Texas-Arlington. We wish to thank Rachel Hess, MD, Department of General Internal Medicine, University of Pittsburgh Medical Center, for her help with study implementation. This work was supported by internal funds from the University of Pittsburgh Cancer Institute.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC, USA

    Tamara J. Somers

  2. Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA

    Julie C. Michael, William M. P. Klein & Andrew Baum

  3. University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA

    Andrew Baum

  4. Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Andrew Baum

  5. Pain Prevention and Treatment Research Program, Duke University, 2200 W. Main Street, Ste. 340, Durham, NC, 27705, USA

    Tamara J. Somers

Authors
  1. Tamara J. Somers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie C. Michael
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William M. P. Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew Baum
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tamara J. Somers.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Somers, T.J., Michael, J.C., Klein, W.M.P. et al. Cancer Genetics Service Interest in Women with a Limited Family History of Breast Cancer. J Genet Counsel 18, 339–349 (2009). https://doi.org/10.1007/s10897-009-9224-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10897-009-9224-1

Keywords

Search

Navigation