The effect of an educational intervention on the perceived risk of breast cancer

Alexander, Nicole; Ross, Jonathan M.; Sumner, Walton; Nease, Robert F.; Littenberg, Benjamin

doi:10.1007/bf02599584

Cited by 79 publications

(58 citation statements)

References 19 publications

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“…For instance, many studies have assessed risk perception to test models that posit an association between risk perception and health behavior (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Other research assesses risk perception to detect errors and biases in risk judgments (15)(16)(17)(18), to assess the association between risk judgments and emotion (19)(20)(21)(22)(23)(24)(25), and to increase the accuracy of people's risk perceptions (11,(26)(27)(28). In sum, several important and large bodies of research depend on obtaining accurate assessments of people's risk perception.…”

Section: Introductionmentioning

confidence: 99%

Measuring Perceptions of Breast Cancer Risk

Levy

Shea

Williams

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Accurate measurement of people's risk perceptions is important for numerous bodies of research and in clinical practice, but there is no consensus about the best measure.Objective: This study evaluated three measures of women's breast cancer risk perception by assessing their psychometric and test characteristics. Design: A cross-sectional mailed survey to women from a primary care population asked participants to rate their chance of developing breast cancer in their lifetime on a 0% to 100% numerical scale and a verbal scale with five descriptive categories, and to compare their risk to others (seven categories). Six hundred three of 956 women returned the survey (63.1%), and we analyzed surveys from the 566 women without a self-reported personal history of breast or ovarian cancer. Results: Scores on the numeric, verbal, and comparative measures were correlated with each other (r > 0.50), worry

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Section: Introductionmentioning

confidence: 99%

Measuring Perceptions of Breast Cancer Risk

Levy

Shea

Williams

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…For example, the percentage of women who overestimated their risk after counselling has ranged from 14% to 89% (Evans et al, 1994;Lerman et al, 1995;Lloyd et al, 1996;Watson et al, 1999). Such over-estimation is associated with high levels of anxiety, and unless corrected, may lead to poorly informed decisions regarding breast cancer screening (Lerman et al, 1993;Alexander et al, 1996;Kash, 1996). Thus it is important to identify strategies which will optimise understanding and psychological adjustment, and these strategies are likely to vary according to the presenting characteristics of the women.…”

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confidence: 99%

Tailoring communication in consultations with women from high risk breast cancer families

et al. 2002

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This multicentre study examined the influence of patient demographic, disease status and psychological variables on clinical geneticists/genetic counsellors (consultants) behaviours in initial consultations with women from high-risk breast cancer families. One hundred and fifty-eight women completed a pre-clinic self-report questionnaire. The consultations were audiotaped, transcribed verbatim and coded. Consultants did not vary their behaviour according to women's expectations. However, significantly more aspects of genetic testing were discussed with women who were affected with breast cancer (P50.001), screening and management with unaffected women (P=0.01) and breast cancer prevention with younger women (P=0.01). Prophylactic mastectomy was discussed more frequently with women with medical and allied health training (P=0.02), and prophylactic oophorectomy with women affected with breast cancer (P=0.03), those in non-professional occupations (P=0.04) and with a family history of breast and ovarian cancer (P50.001). Consultants used significantly more behaviours to facilitate understanding with women who were in non-professional occupations (P=0.04); facilitated active patient involvement more with women affected with breast cancer (P50.001) and used more supportive and counselling behaviours with affected women (P=0.02). This study showed that patient demographics were more likely to predict consultants' communication behaviours than the woman's psychological status. Methods to facilitate assessment of psychological morbidity are needed to allow more tailored communication. Previous research has documented consultants' reports of the cancer genetic services typically provided to women from high-risk breast cancer families. These include cancer risk assessment and education, facilitation of genetic testing, pre-and post-test counselling, provision of personally tailored cancer risk management recommendations, and psychosocial counselling and support services (NH and MRC, 1999).A recent survey of Australian clinical geneticists and genetic counsellors identified the provision of individualised care as the single most important goal of genetic counselling (Lobb et al, 2001). These consultants emphasised the variability in women's current levels of expectations and needs when they attend genetic counselling and the importance of tailoring communication accordingly.Studies that have examined levels of breast cancer genetics knowledge among women with a family history of breast cancer (Lerman et al, 1996Hughes et al, 1997;Wonderlick and Fine, 1997;Cull et al, 1998;Bluman et al, 1999;Donovan and Tucker, 2000) have found wide variation in knowledge about many facets of genetic testing, including the cancer risks associated with different genes and different mutations and the effectiveness of interventions, for example screening, chemoprevention, or surgery for reducing risk (Geller et al, 1997;Audrain et al, 1998;Bluman et al, 1999).Similarly, there is wide variation in the accuracy of women's perceptions of their li...

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“…Interestingly, women from families with multiple breast and ovarian cancer cases commonly overestimate their cancer risks [15]. For example, for patients participating in chemoprevention trials, the mean lifetime calculated risk using the Gail model was 15%; however, the median risk perceived by patients was 50% [16]. A survey carried out in the USA found that although 75% of Americans were aware of Angelina Jolie's double mastectomy, fewer than 10% of respondents had the information necessary to accurately interpret her risk of developing cancer relative to a woman unaffected by the BRCA gene mutation [17].…”

Section: The Individual Decision-making Processmentioning

confidence: 99%

Impact of Prophylactic Mastectomy in <b><i>BRCA1/2</i></b> Mutation Carriers

Rhiem

Schmutzler

2014

Breast Care

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Unlike the general decrease in invasive oncologic care, the trend for prophylactic bilateral mastectomy in healthy women and prophylactic contralateral mastectomy in women with unilateral breast cancer is steadily rising. This is even more surprising when considering that for e.g. prophylactic contralateral mastectomy no clear survival benefit has been demonstrated so far. The decision-making process around risk-reducing surgery may be influenced by several conflicting parameters such as the patient's fears and desire to achieve a survival advantage, the surgeon's financial motivations, or the oncologist's paternalistic approach to the above trend. Physicians should support their patients throughout the decision-making process, guide them through the dense fog of information, and encourage them to reconsider all options and alternatives before embarking on an irreversible surgical intervention. Healthy and diseased women should be comprehensively informed about their absolute individual risks for cancer, the benefits and harms of the surgery, alternative preventive strategies, and last but not least the competing risks of preceding carcinomas and cancer in general. Within the framework of non-directive counseling in the specialized centers of the German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC), decision-making aids are being developed with grants from the Federal Ministry of Health and the German Cancer Aid to support women in making conclusive and satisfactory decisions.

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The effect of an educational intervention on the perceived risk of breast cancer

Abstract: Women often substantially overestimate their chances of getting breast cancer. Educational intervention by a physician, including explanation of an individual's calculated risk, can reduce this error. The effect of education appears to persist at least for several months.

Cited by 79 publications

References 19 publications

Measuring Perceptions of Breast Cancer Risk

Measuring Perceptions of Breast Cancer Risk

Tailoring communication in consultations with women from high risk breast cancer families

Impact of Prophylactic Mastectomy in <b><i>BRCA1/2</i></b> Mutation Carriers

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