Psychological issues related to genetic testing for breast cancer

Cindy Lee Carter


Genetic testing for inherited forms of breast cancer is currently available to individuals who want to learn their genetic status for the BRCA1 and BRCA2 genes. As widespread commercial testing becomes available, more and more women will come forward to be tested. However, empirical investigations examining the psychological impact of genetic testing for breast cancer susceptibility are still in the early stages of development. The purpose of the present study was to assess a group of women applying for services at a breast cancer genetics program in order to evaluate their knowledge about genetic testing their perceptions of their risk for having the breast cancer gene, and to test whether a genetic counseling program would be effective in increasing their knowledge about breast cancer genetics. An additional purpose of the study was to explore the psychosocial impact of being involved in a process that night lead to learning that one carried a gene for breast cancer. Fifty-one women involved in a familial breast cancer project at a military medical center, and identified as at risk for inherited breast cancer participated in the project. Participants were assessed regarding knowledge of genetic testing, cancer-specific distress, and global psychological distress at the time of their initial referral to the program and again two months after completing genetic counseling in which they learned whether they were eligible to receive genetic testing provided by the program. In addition, measures of coping style, as well as attitudes, expectations, and intentions related to genetic testing were evaluated. Clinical status (affected or unaffected with breast cancer) and age ( young or old ) served as between subjects variables. The findings indicated that participants improved their knowledge scores on genetic testing after the genetic counseling session at two-month follow-up regardless of their group membership. Neither age nor clinical status significantly affected women's global or cancer-specific distress. Follow-up analyses revealed that almost half of the unaffected participants perceived their risk to be no more than the average women's. Results are discussed and recommendations for future investigations presented.