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Hereditary Cancer in Clinical Practice
Published in: Hereditary Cancer in Clinical Practice 1/2009

Open Access 01-12-2009 | Research

Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy

Authors: Murly BM Tan, Eveline MA Bleiker, Marian BE Menke-Pluymers, Arthur R Van Gool, Silvia van Dooren, Bert N Van Geel, Madeleine MA Tilanus-Linthorst, Karina CM Bartels, Jan GM Klijn, Cecile TM Brekelmans, Caroline Seynaeve

Published in: Hereditary Cancer in Clinical Practice | Issue 1/2009

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Abstract

Background

Women at increased (genetic) risk of breast cancer have to weigh the personal pros and cons of prophylactic mastectomy (PM) as an option to reduce their cancer risk. So far, no routine referral to a psychologist has been investigated for women considering PM. Aim of this study was to asses: 1) the acceptance of the offer of a standard psychological consultation as part of pre-surgical decision-making in high-risk women, 2) reasons for PM and reasons for postponing it, 3) the need for additional psychological interventions, and factors associated, and 4) the frequency of psychiatric/psychological treatment history.

Methods

During a 30 months period, women at high risk considering PM were offered a psychological consultation. The content of these, and follow-up, consultations were analyzed.

Results

Most women (70 out of 73) accepted the psychological consultation, and 81% proceeded with PM. Main reasons for undergoing PM were to reduce anxiety about cancer, and to reduce the cancer risk. Uncertainty about surgery and the need for further information were the reasons given most frequently for postponing PM. Additional psychological support was given to 31% before and 14% after PM. The uptake of additional support was significantly higher in women with a BRCA1/2 mutation. A history of psychiatric/psychological treatment was present in 36%, mainly consisting of depression and grief after death of a mother.

Conclusion

The uptake-rate of the standard psychological consultation indicates a high level of acceptability of this service for women deciding about PM. Since anxiety is one of the main reasons for considering PM, and depression and grief were present in a third, a standard consultation with a psychologist for high-risk women considering PM may be indicated. This may help them arrive at an informed decision, to detect and manage psychological distress, and to plan psychological support services.
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Metadata
Title
Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy
Authors
Murly BM Tan
Eveline MA Bleiker
Marian BE Menke-Pluymers
Arthur R Van Gool
Silvia van Dooren
Bert N Van Geel
Madeleine MA Tilanus-Linthorst
Karina CM Bartels
Jan GM Klijn
Cecile TM Brekelmans
Caroline Seynaeve
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Hereditary Cancer in Clinical Practice / Issue 1/2009
Electronic ISSN: 1897-4287
DOI
https://doi.org/10.1186/1897-4287-7-6

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