Predictive testing for hereditary breast and ovarian cancer: its effect on women

One in ten women opted to have prophylactic mastectomy and nearly half opted to have their ovaries removed in the year following genetic tests which showed they were at risk of hereditary breast and ovarian cancer (HBOC), a Belgian clinical psychologist reported at the 3rd European Breast Cancer Conference in Barcelona today (Wednesday 20 March).

However Ms Erna Claes, who is studying the impact of predictive testing for HBOC, found that women who had been diagnosed as carriers were not significantly more or less distressed after the results of the predictive genetic testing than women who were found not to be carriers. Nor were there significant differences in distress levels before and after the results of genetic testing in either carriers or non-carriers, according to Ms Claes, a clinical psychologist at the Psychosocial Genetics Unit in Leuven, Belgium.

Instead the carriers took practical measures, following the screening recommendations and opting for regular medical examinations. About 10% had a prophylactic mastectomy within a year of the test result. Of the women who were carriers and aged over 35, 37% had had their ovaries removed (oophorectomy) before applying for predictive testing and 44% had prophylactic oophorectomy after the testing.

Ms Claes said there could be a number of reasons why the women reacted in the way that they did. Within our current study group, only a minority of women have chosen to have a prophylactic mastectomy so far. The majority seem to find this procedure too far reaching or consider it will have too much impact on their lives, their partner or their sexual relations. However, long-term follow-up results are needed in order to see whether more women will choose to have prophylactic mastectomy after the predictive genetic test result. It is possible that what happens in their families could have an impact on their choice, for instance if their sister, mother or aunt is diagnosed with breast or ovar

Contact: Emma Mason
Federation of European Cancer Societies

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