Marijke R Wevers1,2, Margreet G E M Ausems2, Senno Verhoef3, Eveline M A Bleiker1, Daniela E E Hahn4, Titia Brouwer2, Frans B L Hogervorst3, Rob B van der Luijt2, Thijs van Dalen5, Evert B Theunissen6, Bart van Ooijen7, Marnix A de Roos8, Paul J Borgstein9, Bart C Vrouenraets10, Eline Vriens11, Wim H Bouma12, Herman Rijna13, Johannes P Vente14, Jacobien M Kieffer1, Heiddis B Valdimarsdottir15, Emiel J Th Rutgers16, Arjen J Witkamp17, Neil K Aaronson1. 1. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 2. Division of Biomedical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands. 3. Family Cancer Clinic, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 4. Department of Psychosocial Counseling, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 5. Division of Surgery, Diakonessen Hospital, Utrecht, The Netherlands. 6. Division of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. 7. Division of Surgery, Meander Medical Center, Amersfoort, The Netherlands. 8. Division of Surgery, Rivierenland Hospital, Tiel, The Netherlands. 9. Division of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. 10. Division of Surgery, St. Lucas Andreas Hospital, Amsterdam, The Netherlands. 11. Division of Surgery, Tergooi Hospitals, Blaricum, The Netherlands. 12. Division of Surgery, Gelre Hospitals, Apeldoorn, The Netherlands. 13. Division of Surgery, Kennemer Gasthuis, Haarlem, The Netherlands. 14. Division of Surgery, Zuwe Hofpoort Hospital, Woerden, The Netherlands. 15. Department of Psychology, Reykjavik University, Reykjavik, Iceland. 16. Division of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 17. Division of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract
PURPOSE: Female breast cancer patients carrying a BRCA1/2 mutation have an increased risk of second primary breast cancer. Rapid genetic counseling and testing (RGCT) before surgery may influence choice of primary surgical treatment. In this article, we report on the psychosocial impact of RGCT. METHODS: Newly diagnosed breast cancer patients at risk for carrying a BRCA1/2 mutation were randomized to an intervention group (offer of RGCT) or a usual care control group (ratio 2:1). Psychosocial impact and quality of life were assessed with the Impact of Events Scale, Hospital Anxiety and Depression Scale, Cancer Worry Scale, and the EORTC QLQ-C30 and QLQ-BR23. Assessments took place at study entry and at 6- and 12-month follow-up visits. RESULTS: Between 2008 and 2010, 265 patients were recruited into the study. Completeness of follow-up data was more than 90%. Of the 178 women in the intervention group, 177 had genetic counseling, of whom 71 (40%) had rapid DNA testing and 59 (33%) received test results before surgery. Intention-to-treat and per-protocol analyses showed no statistically significant differences between groups over time in any of the psychosocial outcomes. CONCLUSIONS: In this study, RGCT in newly diagnosed breast cancer patients did not have any measurable adverse psychosocial effects.
PURPOSE: Female breast cancer patients carrying a BRCA1/2 mutation have an increased risk of second primary breast cancer. Rapid genetic counseling and testing (RGCT) before surgery may influence choice of primary surgical treatment. In this article, we report on the psychosocial impact of RGCT. METHODS: Newly diagnosed breast cancer patients at risk for carrying a BRCA1/2 mutation were randomized to an intervention group (offer of RGCT) or a usual care control group (ratio 2:1). Psychosocial impact and quality of life were assessed with the Impact of Events Scale, Hospital Anxiety and Depression Scale, Cancer Worry Scale, and the EORTC QLQ-C30 and QLQ-BR23. Assessments took place at study entry and at 6- and 12-month follow-up visits. RESULTS: Between 2008 and 2010, 265 patients were recruited into the study. Completeness of follow-up data was more than 90%. Of the 178 women in the intervention group, 177 had genetic counseling, of whom 71 (40%) had rapid DNA testing and 59 (33%) received test results before surgery. Intention-to-treat and per-protocol analyses showed no statistically significant differences between groups over time in any of the psychosocial outcomes. CONCLUSIONS: In this study, RGCT in newly diagnosed breast cancer patients did not have any measurable adverse psychosocial effects.
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