Skip to main content
NCBI home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1996 Aug;74(3):482–487. doi: 10.1038/bjc.1996.387

Familial breast cancer: a controlled study of risk perception, psychological morbidity and health beliefs in women attending for genetic counselling.

S Lloyd 1, M Watson 1, B Waites 1, L Meyer 1, R Eeles 1, S Ebbs 1, A Tylee 1
PMCID: PMC2074635  PMID: 8695370

Abstract

The present study set out to evaluate perceptions of risk, psychological morbidity and health behaviours in women with a family history of breast cancer who have attended genetic counselling and determine how these differ from general population risk women. Data were collected from 62 genetic counselees (cases) attending the Royal Marsden and Mayday University Hospital genetic counselling services and 62 matched GP attenders (controls). Levels of general psychological morbidity were found to be similar between cases and controls; however, cases reported significantly higher breast cancer-specific distress despite clinic attendance [mean (s.d.) total Impact of Event Scale score, 14.1 (14.3) cases; 2.4 (6.7) controls, P < 0.001]. Although cases perceived themselves to be more susceptible to breast cancer, many women failed correctly to recall risk figures provided by the clinic; 66% could not accurately recall their own lifetime chance. Clinics appeared to have a positive impact on preventive behaviours and cases tended to engage more regularly in breast self-examination (monthly, 66% of cases vs 47% of controls), although few differences were found between groups in terms of health beliefs. We conclude that counselees and GP controls showed considerable similarities on many of the outcome measures, and risk of breast cancer was not predictive of greater psychological morbidity; although cases were more vulnerable to cancer-specific distress. Despite genetic counselling, many cases continued to perceive their risk of breast cancer inaccurately.

Full text

PDF
482

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Austoker J. Screening and self examination for breast cancer. BMJ. 1994 Jul 16;309(6948):168–174. doi: 10.1136/bmj.309.6948.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Austoker J. Screening and self examination for breast cancer. BMJ. 1994 Jul 16;309(6948):168–174. doi: 10.1136/bmj.309.6948.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Claus E. B., Risch N., Thompson W. D. Genetic analysis of breast cancer in the cancer and steroid hormone study. Am J Hum Genet. 1991 Feb;48(2):232–242. [PMC free article] [PubMed] [Google Scholar]
  4. Claus E. B., Risch N., Thompson W. D. Genetic analysis of breast cancer in the cancer and steroid hormone study. Am J Hum Genet. 1991 Feb;48(2):232–242. [PMC free article] [PubMed] [Google Scholar]
  5. Evans A. M., Love R. R., Meyerowitz B. E., Leventhal H., Nerenz D. R. Factors associated with active participation in a Cancer Prevention Clinic. Prev Med. 1985 May;14(3):358–371. doi: 10.1016/0091-7435(85)90062-3. [DOI] [PubMed] [Google Scholar]
  6. Evans A. M., Love R. R., Meyerowitz B. E., Leventhal H., Nerenz D. R. Factors associated with active participation in a Cancer Prevention Clinic. Prev Med. 1985 May;14(3):358–371. doi: 10.1016/0091-7435(85)90062-3. [DOI] [PubMed] [Google Scholar]
  7. Evans D. G., Blair V., Greenhalgh R., Hopwood P., Howell A. The impact of genetic counselling on risk perception in women with a family history of breast cancer. Br J Cancer. 1994 Nov;70(5):934–938. doi: 10.1038/bjc.1994.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Evans D. G., Blair V., Greenhalgh R., Hopwood P., Howell A. The impact of genetic counselling on risk perception in women with a family history of breast cancer. Br J Cancer. 1994 Nov;70(5):934–938. doi: 10.1038/bjc.1994.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Evans D. G., Burnell L. D., Hopwood P., Howell A. Perception of risk in women with a family history of breast cancer. Br J Cancer. 1993 Mar;67(3):612–614. doi: 10.1038/bjc.1993.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Evans D. G., Burnell L. D., Hopwood P., Howell A. Perception of risk in women with a family history of breast cancer. Br J Cancer. 1993 Mar;67(3):612–614. doi: 10.1038/bjc.1993.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Fischhoff B., Bostrom A., Quadrel M. J. Risk perception and communication. Annu Rev Public Health. 1993;14:183–203. doi: 10.1146/annurev.pu.14.050193.001151. [DOI] [PubMed] [Google Scholar]
  12. Fischhoff B., Bostrom A., Quadrel M. J. Risk perception and communication. Annu Rev Public Health. 1993;14:183–203. doi: 10.1146/annurev.pu.14.050193.001151. [DOI] [PubMed] [Google Scholar]
  13. Ford D., Easton D. F., Peto J. Estimates of the gene frequency of BRCA1 and its contribution to breast and ovarian cancer incidence. Am J Hum Genet. 1995 Dec;57(6):1457–1462. [PMC free article] [PubMed] [Google Scholar]
  14. Ford D., Easton D. F., Peto J. Estimates of the gene frequency of BRCA1 and its contribution to breast and ovarian cancer incidence. Am J Hum Genet. 1995 Dec;57(6):1457–1462. [PMC free article] [PubMed] [Google Scholar]
  15. Hailey B. J. Family history of breast cancer and screening behavior: an inverted U-shaped curve? Med Hypotheses. 1991 Dec;36(4):397–403. doi: 10.1016/0306-9877(91)90019-u. [DOI] [PubMed] [Google Scholar]
  16. Hailey B. J. Family history of breast cancer and screening behavior: an inverted U-shaped curve? Med Hypotheses. 1991 Dec;36(4):397–403. doi: 10.1016/0306-9877(91)90019-u. [DOI] [PubMed] [Google Scholar]
  17. Horowitz M., Wilner N., Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979 May;41(3):209–218. doi: 10.1097/00006842-197905000-00004. [DOI] [PubMed] [Google Scholar]
  18. Horowitz M., Wilner N., Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979 May;41(3):209–218. doi: 10.1097/00006842-197905000-00004. [DOI] [PubMed] [Google Scholar]
  19. Houlston R. S., Lemoine L., McCarter E., Harrington S., MacDermot K., Hinton J., Berger L., Slack J. Screening and genetic counselling for relatives of patients with breast cancer in a family cancer clinic. J Med Genet. 1992 Oct;29(10):691–694. doi: 10.1136/jmg.29.10.691. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Houlston R. S., Lemoine L., McCarter E., Harrington S., MacDermot K., Hinton J., Berger L., Slack J. Screening and genetic counselling for relatives of patients with breast cancer in a family cancer clinic. J Med Genet. 1992 Oct;29(10):691–694. doi: 10.1136/jmg.29.10.691. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. JANIS I. L., FESHBACH S. Effect of fear-arousing communications. J Abnorm Psychol. 1953 Jan;48(1):78–92. doi: 10.1037/h0060732. [DOI] [PubMed] [Google Scholar]
  22. JANIS I. L., FESHBACH S. Effect of fear-arousing communications. J Abnorm Psychol. 1953 Jan;48(1):78–92. doi: 10.1037/h0060732. [DOI] [PubMed] [Google Scholar]
  23. Janz N. K., Becker M. H. The Health Belief Model: a decade later. Health Educ Q. 1984 Spring;11(1):1–47. doi: 10.1177/109019818401100101. [DOI] [PubMed] [Google Scholar]
  24. Janz N. K., Becker M. H. The Health Belief Model: a decade later. Health Educ Q. 1984 Spring;11(1):1–47. doi: 10.1177/109019818401100101. [DOI] [PubMed] [Google Scholar]
  25. Kash K. M., Holland J. C., Halper M. S., Miller D. G. Psychological distress and surveillance behaviors of women with a family history of breast cancer. J Natl Cancer Inst. 1992 Jan 1;84(1):24–30. doi: 10.1093/jnci/84.1.24. [DOI] [PubMed] [Google Scholar]
  26. Kash K. M., Holland J. C., Halper M. S., Miller D. G. Psychological distress and surveillance behaviors of women with a family history of breast cancer. J Natl Cancer Inst. 1992 Jan 1;84(1):24–30. doi: 10.1093/jnci/84.1.24. [DOI] [PubMed] [Google Scholar]
  27. Lauver D., Angerame M. Development of a questionnaire to measure beliefs and attitudes about breast self-examination. Cancer Nurs. 1988 Feb;11(1):51–57. [PubMed] [Google Scholar]
  28. Lauver D., Angerame M. Development of a questionnaire to measure beliefs and attitudes about breast self-examination. Cancer Nurs. 1988 Feb;11(1):51–57. [PubMed] [Google Scholar]
  29. Lerman C., Daly M., Masny A., Balshem A. Attitudes about genetic testing for breast-ovarian cancer susceptibility. J Clin Oncol. 1994 Apr;12(4):843–850. doi: 10.1200/JCO.1994.12.4.843. [DOI] [PubMed] [Google Scholar]
  30. Lerman C., Daly M., Masny A., Balshem A. Attitudes about genetic testing for breast-ovarian cancer susceptibility. J Clin Oncol. 1994 Apr;12(4):843–850. doi: 10.1200/JCO.1994.12.4.843. [DOI] [PubMed] [Google Scholar]
  31. 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. 1993 Jul 7;85(13):1074–1080. doi: 10.1093/jnci/85.13.1074. [DOI] [PubMed] [Google Scholar]
  32. 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. 1993 Jul 7;85(13):1074–1080. doi: 10.1093/jnci/85.13.1074. [DOI] [PubMed] [Google Scholar]
  33. Rutledge D. N., Davis G. T. Breast self-examination compliance and the health belief model. Oncol Nurs Forum. 1988 Mar-Apr;15(2):175–179. [PubMed] [Google Scholar]
  34. Rutledge D. N., Davis G. T. Breast self-examination compliance and the health belief model. Oncol Nurs Forum. 1988 Mar-Apr;15(2):175–179. [PubMed] [Google Scholar]
  35. Shiloh S., Sagi M. Effect of framing on the perception of genetic recurrence risks. Am J Med Genet. 1989 May;33(1):130–135. doi: 10.1002/ajmg.1320330121. [DOI] [PubMed] [Google Scholar]
  36. Shiloh S., Sagi M. Effect of framing on the perception of genetic recurrence risks. Am J Med Genet. 1989 May;33(1):130–135. doi: 10.1002/ajmg.1320330121. [DOI] [PubMed] [Google Scholar]
  37. Steel M., Thompson A., Clayton J. Genetic aspects of breast cancer. Br Med Bull. 1991 Apr;47(2):504–518. doi: 10.1093/oxfordjournals.bmb.a072488. [DOI] [PubMed] [Google Scholar]
  38. Steel M., Thompson A., Clayton J. Genetic aspects of breast cancer. Br Med Bull. 1991 Apr;47(2):504–518. doi: 10.1093/oxfordjournals.bmb.a072488. [DOI] [PubMed] [Google Scholar]
  39. Vogel V. G., Graves D. S., Vernon S. W., Lord J. A., Winn R. J., Peters G. N. Mammographic screening of women with increased risk of breast cancer. Cancer. 1990 Oct 1;66(7):1613–1620. doi: 10.1002/1097-0142(19901001)66:7<1613::aid-cncr2820660728>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  40. Vogel V. G., Graves D. S., Vernon S. W., Lord J. A., Winn R. J., Peters G. N. Mammographic screening of women with increased risk of breast cancer. Cancer. 1990 Oct 1;66(7):1613–1620. doi: 10.1002/1097-0142(19901001)66:7<1613::aid-cncr2820660728>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  41. Watson M., Murday V., Lloyd S., Ponder B., Averill D., Eeles R. Genetic testing in breast/ovarian cancer (BRCA1) families. Lancet. 1995 Aug 26;346(8974):583–583. doi: 10.1016/s0140-6736(95)91424-2. [DOI] [PubMed] [Google Scholar]
  42. Watson M., Murday V., Lloyd S., Ponder B., Averill D., Eeles R. Genetic testing in breast/ovarian cancer (BRCA1) families. Lancet. 1995 Aug 26;346(8974):583–583. doi: 10.1016/s0140-6736(95)91424-2. [DOI] [PubMed] [Google Scholar]
  43. Wellisch D. K., Gritz E. R., Schain W., Wang H. J., Siau J. Psychological functioning of daughters of breast cancer patients. Part I: Daughters and comparison subjects. Psychosomatics. 1991 Summer;32(3):324–336. doi: 10.1016/S0033-3182(91)72072-0. [DOI] [PubMed] [Google Scholar]
  44. Wellisch D. K., Gritz E. R., Schain W., Wang H. J., Siau J. Psychological functioning of daughters of breast cancer patients. Part I: Daughters and comparison subjects. Psychosomatics. 1991 Summer;32(3):324–336. doi: 10.1016/S0033-3182(91)72072-0. [DOI] [PubMed] [Google Scholar]
  45. Wellisch D. K., Gritz E. R., Schain W., Wang H. J., Siau J. Psychological functioning of daughters of breast cancer patients. Part II: Characterizing the distressed daughter of the breast cancer patient. Psychosomatics. 1992 Spring;33(2):171–179. doi: 10.1016/S0033-3182(92)71993-8. [DOI] [PubMed] [Google Scholar]
  46. Wellisch D. K., Gritz E. R., Schain W., Wang H. J., Siau J. Psychological functioning of daughters of breast cancer patients. Part II: Characterizing the distressed daughter of the breast cancer patient. Psychosomatics. 1992 Spring;33(2):171–179. doi: 10.1016/S0033-3182(92)71993-8. [DOI] [PubMed] [Google Scholar]
  47. Wooster R., Bignell G., Lancaster J., Swift S., Seal S., Mangion J., Collins N., Gregory S., Gumbs C., Micklem G. Identification of the breast cancer susceptibility gene BRCA2. Nature. 1995 Dec 21;378(6559):789–792. doi: 10.1038/378789a0. [DOI] [PubMed] [Google Scholar]
  48. Wooster R., Bignell G., Lancaster J., Swift S., Seal S., Mangion J., Collins N., Gregory S., Gumbs C., Micklem G. Identification of the breast cancer susceptibility gene BRCA2. Nature. 1995 Dec 21;378(6559):789–792. doi: 10.1038/378789a0. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES