Anxiety, depression, cancer-specific distress and perceived control in breast cancer women tested for BRCA1/2 mutation: effect of test result and perceived predisposition risk accuracy — ASN Events
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  2. IPOS - What if? Psychosocial issues associated with increased genetic risk of cancer
  3. Anxiety, depression, cancer-specific distress and perceived control in breast cancer women tested for BRCA1/2 mutation: effect of test result and perceived predisposition risk accuracy

Anxiety, depression, cancer-specific distress and perceived control in breast cancer women tested for BRCA1/2 mutation: effect of test result and perceived predisposition risk accuracy (#269)

Anne Bredart 1 , Jean-Luc Kop 2 , Antoine Depauw 1 , Serge Sultan 3 , Olivier Caron 4 , Débora Leblond 1 , Dominique Stoppa-Lyonnet 1 , Christelle Colas 5 , Catherine Noguès 1 , Sylvie Dolbeault 1
  1. Institut Curie, Paris, IDF, France
  2. Inter-Psy, Université de Lorraine, Nancy, France
  3. Psychology, Montreal University, CHU Sainte-Justine, Montreal, Canada
  4. Genetic clinic, Institut Gustave Roussy, Villejuif, France
  5. Genetic clinic, Hôpital La Pitié-Salpétrière, Paris, France

Aims: To assess the effect of a BRCA1/2 uninformative, unclassified-variant (UV) or pathogenic-mutation test result on breast cancer (BC) women anxiety, depression, cancer-related thoughts intrusion or avoidance, and perceived personal control, and the effect of their perceived predisposition risk accuracy according to their BRCA1/2 test result, controlling for socio-demographics, medical status and perceived cancer risks.
Methods: Among 273 BC women recruited, 243 (89%) completed HADS, IES and PPC scales after initial cancer genetic consultation (T1) and 180 (62%) also post BRCA1/2 test result communication (T2). Most women were undergoing BC treatment (52%). 74% women received an uninformative, 11% a pathogenic-mutation, and 15% an unclassified variant BRCA1/2 test result.
Results: High rates of clinical cases of anxiety and avoidance were evidenced at T1 (24%, 14%) and T2 (31%, 18%). In hierarchical regression analysis, the percentage of score variance (adjusted R2) in anxiety, depression, cancer-related thoughts intrusion or avoidance, and perceived personal control at T2 ranged from 22% to 35%, mainly predicted by T1 scores. Receiving a BRCA1/2 pathogenic-mutation test result or UV, versus an uninformative test result significantly increased the level of intrusive thoughts (β=.27; p<.05 and β=.24; p<.01). Significant interactions were found between BRCA1/2 test result and inadequate predisposition risk perception: in women receiving a pathogenic-mutation test result (versus uninformative), an overestimation of predisposition risk at T1 predicted higher levels of anxiety at T2 (p<.001) and in women receiving a UV test result (versus uninformative), an underestimation of predisposition risk at T1 predicted higher levels of anxiety (p<.001), depression (p<.01) and intrusion (p<.001) at T2.
Conclusions: The process of BRCA1/2 testing is associated to a high level of distress in a significant number of women, especially in women receiving a pathogenic-mutation or an UV test result who initially misperceived their predisposition risk.