Patient-centered care in breast cancer genetic clinics

With advances in breast cancer (BC) gene panel testing, risk counseling has become increasingly complex, potentially leading to unmet psychosocial needs. We assessed psychosocial needs and correlates in women initiating testing for high genetic BC risk in clinics in France and Germany, and compared...

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Detalles Bibliográficos
Autores: Brédart, Anne|||0000-0002-1864-5371, Anota, Amélie, Dick, Julia|||0000-0003-3325-7892, Kuboth, Violetta, Lareyre, Olivier, De Pauw, Antoine|||0000-0003-3898-073X, Cano, Alejandra, Stoppa-Lyonnet, Dominique|||0000-0002-5438-8309, Schmutzler, Rita, Dolbeault, Sylvie, Kop, Jean-Luc|||0000-0002-6963-8411
Tipo de recurso: artículo
Fecha de publicación:2018
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:188588
Acceso en línea:https://ddd.uab.cat/record/188588
https://dx.doi.org/urn:doi:10.3390/ijerph15020319
Access Level:acceso abierto
Palabra clave:Breast cancer
Genetic risk
Risk counseling
Psychosocial needs
Distress
Service delivery
Culture
Descripción
Sumario:With advances in breast cancer (BC) gene panel testing, risk counseling has become increasingly complex, potentially leading to unmet psychosocial needs. We assessed psychosocial needs and correlates in women initiating testing for high genetic BC risk in clinics in France and Germany, and compared these results with data from a literature review. Among the 442 counselees consecutively approached, 212 (83%) in France and 180 (97%) in Germany, mostly BC patients (81% and 92%, respectively), returned the 'Psychosocial Assessment in Hereditary Cancer' questionnaire. Based on the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) BC risk estimation model, the mean BC lifetime risk estimates were 19% and 18% in France and Germany, respectively. In both countries, the most prevalent needs clustered around the "living with cancer" and "children-related issues" domains. In multivariate analyses, a higher number of psychosocial needs were significantly associated with younger age (b = -0.05), higher anxiety (b = 0.78), and having children (b = 1.51), but not with country, educational level, marital status, depression, or loss of a family member due to hereditary cancer. These results are in line with the literature review data. However, this review identified only seven studies that quantitatively addressed psychosocial needs in the BC genetic counseling setting. Current data lack understandings of how cancer risk counseling affects psychosocial needs, and improves patient-centered care in that setting