TY - JOUR
T1 - Time to prophylactic surgery in BRCA1/2 carriers depends on psychological and other characteristics
AU - Julian-Reynier, Claire
AU - Bouhnik, Anne Déborah
AU - Mouret-Fourme, Emanuelle
AU - Gauthier-Villars, Marion
AU - Berthet, Pascaline
AU - Lasset, Christine
AU - Fricker, Jean Pierre
AU - Caron, Olivier
AU - Gesta, Paul
AU - Luporsi, Elisabeth
AU - Faivre, Laurence
AU - Longy, Michel
AU - Gladieff, Laurence
AU - Frenay, Marc
AU - Dreyfus, Héléne
AU - Sobol, Hagay
AU - Vennin, Philippe
AU - Nogués, Catherine
PY - 2010/1/1
Y1 - 2010/1/1
N2 - Purpose: To investigate the medical and psychosocial factors determining the time to prophylactic surgery of unaffected women carriers of a deleterious BRCA1/2 mutation. Methods: Prospective study on a French national cohort of unaffected BRCA1/2 carriers (N = 244); multivariate Cox proportional hazard modeling. Results: Median follow-up time was 2.33 years (range, 0.04-6.84 years). Time to surgery was shorter when the psychological impact of BRCA1/2 result disclosure was stated to be higher (P ≤ 0.01). Those who intended to opt for prophylactic surgery before being tested did so faster and more frequently after test disclosure than those who were undecided/opposed. The older the women were, the faster their uptake of risk-reducing salpingo-oophorectomy (adjusted hazard ratio >2.95; P < 0.001) was; the uptake of those with at least two children was also faster (adjusted hazard ratio = 2.51; [1.38-4.55]). Those who opted most quickly for risk-reducing mastectomy more frequently had a younger child at the time of testing (adjusted hazard ratio = 4.63 [1.56-13.74]). Time to surgery was shorter when there was a first-degree relative with ovarian/breast cancer (P ≤ 0.01). Conclusion: Time to prophylactic surgery depends on the stated psychological impact of disclosure and on women's cognitive anticipation of surgery after adjusting on sociodemographic characteristics.
AB - Purpose: To investigate the medical and psychosocial factors determining the time to prophylactic surgery of unaffected women carriers of a deleterious BRCA1/2 mutation. Methods: Prospective study on a French national cohort of unaffected BRCA1/2 carriers (N = 244); multivariate Cox proportional hazard modeling. Results: Median follow-up time was 2.33 years (range, 0.04-6.84 years). Time to surgery was shorter when the psychological impact of BRCA1/2 result disclosure was stated to be higher (P ≤ 0.01). Those who intended to opt for prophylactic surgery before being tested did so faster and more frequently after test disclosure than those who were undecided/opposed. The older the women were, the faster their uptake of risk-reducing salpingo-oophorectomy (adjusted hazard ratio >2.95; P < 0.001) was; the uptake of those with at least two children was also faster (adjusted hazard ratio = 2.51; [1.38-4.55]). Those who opted most quickly for risk-reducing mastectomy more frequently had a younger child at the time of testing (adjusted hazard ratio = 4.63 [1.56-13.74]). Time to surgery was shorter when there was a first-degree relative with ovarian/breast cancer (P ≤ 0.01). Conclusion: Time to prophylactic surgery depends on the stated psychological impact of disclosure and on women's cognitive anticipation of surgery after adjusting on sociodemographic characteristics.
KW - BRCA1/2
KW - breast cancer
KW - genetic testing
KW - prophylactic surgery
KW - psychosocial
UR - http://www.scopus.com/inward/record.url?scp=78650679238&partnerID=8YFLogxK
U2 - 10.1097/GIM.0b013e3181f48d1c
DO - 10.1097/GIM.0b013e3181f48d1c
M3 - Article
C2 - 20921896
AN - SCOPUS:78650679238
SN - 1098-3600
VL - 12
SP - 801
EP - 807
JO - Genetics in Medicine
JF - Genetics in Medicine
IS - 12
ER -