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Breast cancer screening uptake in women at increased risk of developing hereditary breast cancer

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Abstract

This multicenter study assessed breast cancer screening uptake in 461 unaffected women at increased risk of developing breast cancer on the basis of family history who approached familial cancer clinics for advice about surveillance options. At the time of attending the clinic, 89% and 90% of participants were vigilant with respect to age- and risk-specific recommendations for mammography and clinical breast examination, respectively, and 51% reported practicing breast self-examination monthly or more frequently. The degree to which health outcomes are perceived to be under one's personal control (χ2=−2.09, p=0.0037) and breast cancer anxiety (χ2=8.11,p=0.044) were both associated with monthly or more frequent breast self-examination, while there were no associations with sociodemographic characteristics. A significantly lower percentage (56%) of women aged <30 were vigilant with respect to mammography recommendations, compared to 77%, 96% and 98% of women aged 30–39, 40–49 and >50, respectively (χ2=37.2,p<0.0001). These relatively low rates of mammographic screening in young women may reflect concerns about increased cancer risk associated with early and repeated radiation exposure or lack of sensitivity in young women with radiographically dense breasts. If mammographic screening is ultimately shown to lower mortality in women at high risk, there will be a strong case to promote screening in young women. The need for regular mammographic screening would then need to be highlighted and reinforced amongst young women and their referring physicians. Awareness amongst general practitioners, who are largely responsible for referral to screening services, would also need to be increased.

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References

  1. Goldgar DE, Stratton MR, Eeles RA: Familial breast cancer. In: Eeles RA, Ponder BAJ, Easton DF, and Horwich A (eds) Genetic predisposition to cancer. Chapman & Hall, London, 1996, pp. 227–238

    Google Scholar 

  2. Hall JM, Lee MK, Newman B, Morrow J, Anderson L, Huey B, King M: Linkage analysis of early- onset familial breast cancer to chromosome 17q12. Science 250: 1684–1689, 1990

    Google Scholar 

  3. Miki Y, Swensen J, Shattuck-Eidens D, Futreal A, Harshrnan K, Tavtigian S, et al.: A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science 266: 66–71, 1994

    Google Scholar 

  4. Wooster R, Neuhausen SL, Mangion J, Quirk Y, Ford D, Collins N, et al.: Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12-13. Science 265: 2088–2090, 1994

    Google Scholar 

  5. Wooster R, Bignell G, Lancaster J, Swift S, Seal S, Mangion J, et al.: Identification of the breast cancer susceptibility gene BRCA2. Nature 378: 789–792, 1995

    Google Scholar 

  6. Easton D: Breast cancer genes — What are the real risks? Nature Genet 16: 210–211, 1997

    Google Scholar 

  7. Whittemore AS, Gong G, Itnyre J: Prevalence and contribution of BRCA1 mutations in breast cancer and ovarian cancer: Results from three US population-based case-control studies of ovarian cancer. Am J Human Genet 60: 496–504, 1997

    Google Scholar 

  8. Struewing JP, Hartge P, Wacholder S, Baker SM, Berlin M, McAdams M, Timmerman MM, Brody LC, Tucker MA: The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. New Engl J Med 336: 1401–1408, 1997

    Google Scholar 

  9. Report of the Organising Committee and Collaborators: Breast cancer screening with mammography in women aged 40- 49 years. Int J Cancer 68: 693–699, 1996

    Google Scholar 

  10. Kerlikowske K, Grady D, Barclay J, Sickles EA, Eaton A, Ernster V: Effect of age, breast density and family history on the sensitivity of first screening mammography. JAMA 276: 33–38, 1996

    Google Scholar 

  11. Thomas DB, Gao DL, Self SG, Allison CJ, Tao Y, Mahloch J, Ray R, Qin Q, Preseley R, Porter P: Randomized trial of breast self-examinaton in Shanghai: Methodology and preliminary results. J Natl Cancer Inst 89: 355–365, 1997

    Google Scholar 

  12. Semiglazov VF, Sagaidak VN, Moiseenko VM, Mikhailov EA: Study of the role of breast self-examination in the reduction of mortality from breast cancer: The Russian Federation/ World Health Organization Study. Eur J Cancer 29A: 2039–2046, 1992

    Google Scholar 

  13. UK Trial of Early Detection of Breast Cancer Group: Breast cancer mortality after 10 years in the UK trial of early detection of breast cancer. The Breast 2: 13–20, 1993

    Google Scholar 

  14. Burke W, Daly M, Garber J, Botkin J, Kahn MJE, Lynch P, McTieman A, Offit K, Perlman J, Petersen G, Thomson E, Varricchio C: For the Cancer Genetics Studies Consortium: Recommendations for follow-up care of individuals with an inherited predisposition to cancer. II. BRCA1 and BRCA2. JAMA 277: 997–1003, 1997

    Google Scholar 

  15. Kollias J, Sibbering DM, Blamey RW, Holland PAM, Obuszko Z, Wilson ARM, Evans AJ, Ellis IO, Elston CW: Screening women aged less than 50 years with a family history of breast cancer. Eur J Cancer 34: 878–883, 1998

    Google Scholar 

  16. Kirk J, Tucker K: National Best Practice Guidelines for Familial Cancer Clinics. NHMRC National Breast Cancer Centre, Sydney, 1997

    Google Scholar 

  17. Eisinger F, Alby N, Bremond A, Dauplat J, Espie M, Janiaud P, Kuttenn F, Lebrun JP, Lefranc JB, Pierret J, Sobol H, Stoppa-Lyonnet D, Thouvenin D, Tristant H, Feingold J: Recommendations for medical management of hereditary breast and ovarian cancer: The French National Ad Hoc Committee. Ann Oncol 9: 939–950, 1998

    Google Scholar 

  18. Weber BL, Giusti RM, Liu ET: Developing strategies for intervention and prevention in hereditary breast cancer. J Natl Cancer Inst Monograph 17: 115–118, 1995

    Google Scholar 

  19. Bondy ML, Vogel VG, Halabi S, Lustbader ED: Identification of women at increased risk for breast cancer in a populationbased screening program. Cancer Epidemiol Biomarkers Prev 1: 143–147, 1992

    Google Scholar 

  20. Kaplan K, Weinberg GB, Small A, Herndon JL: Breast cancer screening among relatives of women with breast cancer. Am J Pub Health 81: 1174–1179, 1991

    Google Scholar 

  21. Vogel VG, Schreiber D, Graves D, Vernon SW, Lord JA, Winn RJ, Peters GN: Mammographic screening of women with increased risk of breast cancer. Cancer 66: 1613–1620, 1990

    Google Scholar 

  22. Audrain J, Lerman C, Rimer B, Cella D, Steffens R, Gomez-Caminero A: The High Risk Breast Cancer Consortium: Awareness of heightened breast cancer risk among first-degree relatives of recently diagnosed breast cancer patients. Cancer Epidemiol Biomarkers Prev 4: 561–565, 1995

    Google Scholar 

  23. Houts PS, Wojkowiak SL, Simmonds MA, Weinberg GB, Heitjan DF: Using a state cancer registry to increase screening behaviours of sisters and daughters of breast cancer patients. Am J Pub Health 81: 386–388, 1991

    Google Scholar 

  24. Polednak AP, Lane DS, Burg MA: Risk perception, family history, and the use of breast cancer screening tests. Cancer Detec Prev 15: 257–263, 1991

    Google Scholar 

  25. Lerman C, Daly M, Sands C, Balshem A, Lustbader E, Heggan T, Goldstein L, James J, Engstrom P: Mammography adherence and psychological distress among women at risk for breast cancer. J Natl Cancer Inst 85: 1074–1080, 1993

    Google Scholar 

  26. Stefanek ME, Wilcox P: First degree relatives of breast cancer patients: Screening practices and provision of risk information. Cancer Detec Prev 15: 379–384, 1991

    Google Scholar 

  27. Kash KM: Psychological distress associated with genetic breast cancer risk. In: Eeles RA, Ponder BAJ, Easton DF, and Horwich A (eds) Genetic predisposition to cancer. Chapman & Hall, London, 1996, pp. 282–289

    Google Scholar 

  28. Lloyd S, Watson M, Waites B: Familial breast cancer: A controlled study of risk perception, psychological morbidity and health beliefs in women attending for genetic counselling. Br J Cancer 74: 482–487, 1996

    Google Scholar 

  29. Alagna SW, Morokoff PJ, Bevett JM, Reddy DM: Performance of breast self-examination by women at high risk for breast cancer. Women Health 12: 29–46, 1987

    Google Scholar 

  30. DalyMB, Lerman CL, Ross E, Schwartz MD, Burke, Sands C, Masny A: Gail model breast cancer risk components are poor predictors of risk perception and screening behaviour. Breast Cancer Res Treat 41: 59–70, 1996

    Google Scholar 

  31. Drossaert CCH, Boer H, Seydel ER: Perceived risk, anxiety, mammogram uptake, and breast self-examination of women with a family history of breast cancer: The role of knowing to be at increased risk. Cancer Detec Prev 20: 76–85, 1996

    Google Scholar 

  32. Strickland BR: Internal-external expectancies and healthrelated behaviours. J Consult Clin Psychol 46: 1192–1211, 1978

    Google Scholar 

  33. Wallston KA, Strudler-Wallston B, De Vellis R: Development of the multidimensional health locus of control (MHLC) scales. Health Educ Mono 6: 160–170, 1978

    Google Scholar 

  34. Kash KM, Holland JC, Halper MS, Miller DG: Psychological distress and surveillance behaviours of women with a family history of breast cancer. J Natl Cancer Inst 84: 24–30, 1992

    Google Scholar 

  35. Lerman C, Kash K, Stefanek M: Younger women at increased risk for breast cancer: Perceived risk, psychological well-being and surveillance behaviour. J Natl Cancer Inst Monographs No. 16: 171–176, 1994

    Google Scholar 

  36. Hailey BJ: Family history of breast cancer and screening behaviour: An inverted U-shaped curve? Med Hypothes 36: 397–403, 1991

    Google Scholar 

  37. Miller SM, Shoda Y, Hurley K: Applying cognitive-social theory to health-protective behavior: Breast self-examination in cancer screening. Psychol Bull 119: 70–94, 1996

    Google Scholar 

  38. Lerman C, Schwartz M: Adherence and psychological adjustment among women at high risk for breast cancer. Breast Cancer Res Treat 28: 144–145, 1993

    Google Scholar 

  39. Ford D, Easton DF, Bishop DT: Risks of cancer in BRCA1-mutation carriers. Lancet 343: 692–695, 1994

    Google Scholar 

  40. Easton DF, Bishop DT, Ford D, Crockford GP, and the Breast Cancer Linkage Consortium: Genetic linkage analysis in familial breast and ovarian cancer: Results from 214 families. Am J Human Genet 52: 678–701, 1993

    Google Scholar 

  41. Claus EB, Risch NJ, Thompson WD: Autosomal dominant inheritance of early onset breast cancer. Cancer 73: 643–651, 1994

    Google Scholar 

  42. Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 81: 1879–1886, 1989

    Google Scholar 

  43. Horowitz MJ, Wilner N, Alvarez W: Impact of Event Scale: A measure of subjective stress. Psychosom Med 41: 209–218, 1979

    Google Scholar 

  44. National Breast Cancer Centre: Current best advice about familial aspects of breast cancer. NHMRC National Breast Cancer Centre, Sydney, 1997

    Google Scholar 

  45. Australian Bureau of Statistics: Australian women's year book, Vol. ABS Catalogue No. 4124.0. Australian Bureau of Statistics, Canberra, 1997

    Google Scholar 

  46. Barratt A, Cockburn J, Lowe J, Paul C, Perkins J, Redman S: Report on the 1996 Breast Health Survey. NH & MRC National Breast Cancer Centre, Sydney, 1997

    Google Scholar 

  47. McCaul KD, Dyche Branstetter A, Schroeder DM, Glasgow RE: What is the relationship between breast cancer risk and mammography screening? A meta-analytic review. Health Psychol 15: 423–429, 1996

    Google Scholar 

  48. Meyerowitz BE, Chaiken S: The effect of message framing on breast self-examination attitudes, intentions and behaviour. J Pers Soc Psychol 52: 500–510, 1987

    Google Scholar 

  49. McCaul KD, Schroeder DM, Reid PA: Breast cancer worry and screening: Some prospective data. Health Psychol 15: 430–433, 1996

    Google Scholar 

  50. Cockburn J, Murphy B, Schofield P, Hill D, Borland R: Predictors of intention to attend for screening mammography at the Essendon Breast X-Ray Program. Centre for Behavioural Research in Cancer, Melbourne, 1989

    Google Scholar 

  51. Vernon SW, Laville EA, Jackson GL: Participation in breast screening programs: A review. Soc ScMed 30: 110–118, 1990

    Google Scholar 

  52. Streiner DL, Norman GR: Health measurement scales. Oxford University Press, Oxford:, 1995

    Google Scholar 

  53. Etzi S, Lane DS, Grimson R: The use of mammography vans by low-income women: The accuracy of self-reports. Am J Pub Health 84: 107–109, 1994

    Google Scholar 

  54. Cull A, Miller H, Porterfield T, Mackay J, Anderson EDC, Steel CM, Elton RA: The use of videotaped information in cancer genetic counselling: A randomised evaluation study. Br J Cancer 77: 830–837, 1998

    Google Scholar 

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Authors and Affiliations

  1. Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney

    Bettina Meiser, Michael Friedlander & Katherine Tucker

  2. Medical Psychology Unit, Westmead Hospital, Sydney

    Phyllis Butow

  3. Department of Public Health and Community Medicine, Westmead Hospital, Sydney

    Alexandra Barratt

  4. Familial Cancer Clinic, Westmead Hospital, University of Sydney, Sydney

    Judy Kirk

  5. Victorian Clinical Genetics Services, Melbourne

    Clara Gaff & K. Aittomäki

  6. South Australian Clinical Genetics Service, Women's and Children's Hospital, Adelaide

    Eric Haan

Authors
  1. Bettina Meiser
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  2. Phyllis Butow
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  3. Alexandra Barratt
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  4. Michael Friedlander
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  5. Judy Kirk
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  8. K. Aittomäki
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  9. Katherine Tucker
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Meiser, B., Butow, P., Barratt, A. et al. Breast cancer screening uptake in women at increased risk of developing hereditary breast cancer. Breast Cancer Res Treat 59, 101–111 (2000). https://doi.org/10.1023/A:1006330631832

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