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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2012

01-12-2012 | Healthcare Policy and Outcomes

Cognitive and Psychological Impact of BRCA Genetic Counseling in Before and After Definitive Surgery Breast Cancer Patients

Authors: Juliette Christie, PhD, Gwendolyn P. Quinn, PhD, Teri Malo, PhD, Ji-Hyun Lee, PhD, Xiuhua Zhao, MPH, Jessica McIntyre, BA, Jennifer Brzosowicz, MS, CGC, Paul B. Jacobsen, PhD, Susan T. Vadaparampil, PhD

Published in: Annals of Surgical Oncology | Issue 13/2012

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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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Metadata
Title
Cognitive and Psychological Impact of BRCA Genetic Counseling in Before and After Definitive Surgery Breast Cancer Patients
Authors
Juliette Christie, PhD
Gwendolyn P. Quinn, PhD
Teri Malo, PhD
Ji-Hyun Lee, PhD
Xiuhua Zhao, MPH
Jessica McIntyre, BA
Jennifer Brzosowicz, MS, CGC
Paul B. Jacobsen, PhD
Susan T. Vadaparampil, PhD
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 13/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2460-x

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