Counselling needs of women with a maternal history of breast cancer

Kelly, Patricia T.

doi:10.1016/s0738-3991(80)80052-8

Cited by 18 publications

(11 citation statements)

References 10 publications

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“…Table summarises the 17 included studies, each based on a unique sample. Countries of origin were the United States, the United Kingdom, Canada, Australia, Israel, and the Netherlands.…”

Section: Resultsmentioning

confidence: 99%

How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research

et al. 2017

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ObjectiveRisk‐reducing procedures can be offered to people at increased cancer risk, but many procedures can have iatrogenic effects. People therefore need to weigh risks associated with both cancer and the risk‐reduction procedure in their decisions. By reviewing relevant literature on breast cancer (BC) risk reduction, we aimed to understand how women at relatively high risk of BC perceive their risk and how their risk perceptions influence their decisions about risk reduction.MethodsSynthesis of 15 qualitative studies obtained from systematic searches of SCOPUS, Web of Knowledge, PsychINFO, and Medline electronic databases (inception‐June 2015).ResultsWomen did not think about risk probabilistically. Instead, they allocated themselves to broad risk categories, typically influenced by their own or familial experiences of BC. In deciding about risk‐reduction procedures, some women reported weighing the risks and benefits, but papers did not describe how they did so. For many women, however, an overriding wish to reduce intense worry about BC led them to choose aggressive risk‐reducing procedures without such deliberation.ConclusionsReasoning that categorisation is a fundamental aspect of risk perception, we argue that patients can be encouraged to develop more nuanced and accurate categorisations of their own risk through their interactions with clinicians. Empirically‐based ethical reflection is required to determine whether and when it is appropriate to provide risk‐reduction procedures to alleviate worry.

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“…Table summarises the 17 included studies, each based on a unique sample. Countries of origin were the United States, the United Kingdom, Canada, Australia, Israel, and the Netherlands.…”

Section: Resultsmentioning

confidence: 99%

How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research

et al. 2017

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“…Studies dating from the 1960s have reported that a family history of cancer is associated with emotions such as fear, anxiety, and guilt (8)(9)(10)(11)(12)(13)(14)(15). Recently, in response to increased interest about risk, the mass media has featured many articles about cancer risk, but of course cannot address individual concerns or provide sufficient detail to resolve conflicting information.…”

Section: Emotional Reactions To Cancermentioning

confidence: 99%

“…Reports of cancer risk services reflect a recognition of the importance of presenting information about hereditary and nonhereditary risk factors (1,3), the value of psychosocial services (3,9,34-41), the need to help patients develop a follow-up regimen (1,3,34,(39)(40)(41)(42), the need to assess patients' baseline knowledge and concerns (5,8), and the influence of emotional factors on the risk information counseling process and outcome (1,3,10). Some risk services appear to focus mainly on hereditary risk factors (34,39,40) and include a medical evaluation (40,42).…”

Section: Cancer Risk Information Servicesmentioning

confidence: 99%

Cancer Risk Information Services: Promise and Pitfalls

Kelly

1996

Breast Journal

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As new information about cancer risk and etiology becomes available, physicians are requesting genetic testing for their patients and are expecting that they will receive appropriate information about risk, testing, and test results. Patients' reactions t o risk suggest that the clinically effective presentation of risk information is a complex process, requiring multiple visits with skilled health professionals and includes helping patients t o integrate sophisticated and often surprising information. Unless sufficient time and expertise are devoted to exploring patients' beliefs and concerns, as well as ascertaining and providing information about cancer risk that is relevant t o them, patients may not learn enough t o make informed health care decisions, even with state-of-the-art genetic testing and access t o the latest risk information.

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“…We consider that from an ethical standpoint it is quite acceptable to await a definitive BRCA I gene identification in order to confirm genetic status prior to offering very precise estimates of risk based on specific and personal linkage results. The complex psychosocial aspects of counselling women with a positive family history of breast cancer and who often have inaccurate perceptions of their own risk should not be overlooked (Kelly, 1980;Evans et al , 1991) and give further cause for a cautious clinical approach. At many centres, women with a positive family history are invited to report at high-risk clinics for annual examination.…”

Section: Implica Nonsmentioning

confidence: 99%

Recent Advances In The Genetics Of Heritable Breast Cancer

Porter

Steel²

1993

Disease Markers

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KEY WORDS Breast cancer Genetics p53 BRCA 1 Linkage INTRODUCTION There have been a number of recent advances in the genetics of heritable breast cancer. These are already beginning to influence risk assessment in individuals who are considered potentially susceptible to malignancy on the basis of their family history. It is anticipated that continued progress in this field will eventually lead to the identification of a small, very high risk group of breast cancer gene carriers. Diagnostic organ screening, surgical, and pharmacological prophylaxis will be more cost-effective in this well-defined and not insignificant subpopulation. The early findings of Anderson (1974, 1977) and Lynch et al. (1976, 1979) that first degree relatives of breast cancer patients were at particularly high risk if the index case had either malignancy at young age or bilateral disease have recently been reaffirmed (Houlston et al. , 1992; Tulinius et al., 1992a). Houlston et al. provide graphs which estimate, for first degree relatives of breast cancer patients, probability of disease over 10 years and also lifetime probability, according to age of diagnosis of the index case and age of the sister, mother or daughter requiring assessment. Such relative risks are accurate for the population as a whole, yet absolute risk will obviously vary from family to family if some breast cancer pedigrees represent chance clusters of a common malignancy while others are due to a highly penetrant gene. Confirmation that there is indeed heterogeneity (both a genetic and a non-genetic component) in the aetiology of breast cancer pedigrees has come from several statistical analyses of cancer distribution within the families of breast cancer probands. These studies are known as segregation analyses. The relative likelihood of obtaining the observed distribution of affected and unaffected pedigree members is computed under different genetic models such as single gene autosomal dominant, recessive or polygenic inheritance. In most studies the maximum likelihood score achieved by application of the model of a single autosomal dominant gene with 80-90 per cent lifetime penetrance and carried by 1-6 in every 1000 women has been sufficient to displace other genetic possibilities (Newman et aI., 1988; Claus et al. , 1991; Iselius et al., 1991). In breast cancer pedigrees, some individuals affected by malignancy may be nongene-carriers whereas some unaffected relatives may be gene-carriers who have yet to develop the disease. The relative likelihood that any

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Counselling needs of women with a maternal history of breast cancer

Cited by 18 publications

References 10 publications

How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research

How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research

Cancer Risk Information Services: Promise and Pitfalls

Recent Advances In The Genetics Of Heritable Breast Cancer

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