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. 2012 Dec;19(13):4003-11.
doi: 10.1245/s10434-012-2460-x. Epub 2012 Jul 6.

Cognitive and psychological impact of BRCA genetic counseling in before and after definitive surgery breast cancer patients

Juliette Christie  1 , Gwendolyn P Quinn, Teri Malo, Ji-Hyun Lee, Xiuhua Zhao, Jessica McIntyre, Jennifer Brzosowicz, Paul B Jacobsen, Susan T Vadaparampil
Affiliations

Cognitive and psychological impact of BRCA genetic counseling in before and after definitive surgery breast cancer patients

Juliette Christie et al. Ann Surg Oncol. 2012 Dec.

Abstract

Purpose: To examine changes in cancer-related knowledge, distress, and decisional conflict from pre- to post-genetic counseling (GC) in before (BDS) and after (ADS) definitive surgery breast cancer (BC) patients.

Methods: Sociodemographic and clinical characteristics were collected at baseline; primary outcome data were collected before (T1) and after (T2) pretest GC. Within group changes for cancer-related knowledge, distress, and decisional conflict over genetic testing were compared by Wilcoxon signed-rank tests.

Results: Of 103 BC patients, 87 were ADS and 16 were BDS. Analyses revealed that both groups reported significant increases in knowledge between T1 and T2 (median change 4.2, p = 0.004, and 2.7, p < 0.001, for BDS and ADS patients, respectively). Overall cancer-related distress showed a downward trend between T1 and T2 for both groups and was significant for BDS patients (p = 0.041). Reports of BDS patients trended toward overall and subscale-specific increases in decisional conflict, with the exception of the uncertainty which trended downward, but did not reach significance. Overall decisional conflict decreased in ADS patients, approaching marginal significance (p = 0.056), with significant improvements in informed decision making (median change -12.6, p < 0.001; i.e., pretest GC yielded improved knowledge of benefits, risks, and side effects of available options).

Conclusions: These pilot data suggest that pretest GC increases cancer-related knowledge for both BDS and ADS patients, decreases distress in BDS patients, and improves informed decision making in ADS patients. Future studies with larger sample sizes are needed to replicate these results.

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Conflict of interest statement

Conflict of Interest: The authors have no financial conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Overview of the genetic counseling and testing process. Current analyses are based on T1 (before pretest, or pre-, GC) and T2 (after pretest, or post-, GC) data.
Figure 2
Figure 2
Changes in breast cancer-related distress (overall and by subscales) from pre-to post-GC in before definitive surgery (BDS; n = 16) patients (above panel) and after definitive surgery (ADS; n = 87) patients (below panel); Wilcoxon signed-rank tests conducted to compare median changes over time.
See this image and copyright information in PMC

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