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Published in: Journal of Experimental & Clinical Cancer Research 1/2009

Open Access 01-12-2009 | Research

Subjective versus objective risk in genetic counseling for hereditary breast and/or ovarian cancers

Authors: Anita Caruso, Cristina Vigna, Bruna Marozzo, Fabio M Sega, Isabella Sperduti, Francesco Cognetti, Antonella Savarese

Published in: Journal of Experimental & Clinical Cancer Research | Issue 1/2009

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Abstract

Background

Despite the fact that genetic counseling in oncology provides information regarding objective risks, it can be found a contrast between the subjective and objective risk.
The aims of this study were to evaluate the accuracy of the perceived risk compared to the objective risk estimated by the BRCApro computer model and to evaluate any associations between medical, demographic and psychological variables and the accuracy of risk perception.

Methods

130 subjects were given medical-demographic file, Cancer and Genetic Risk Perception, Hospital Anxiety-Depression Scale. It was also computed an objective evaluation of the risk by the BRCApro model.

Results

The subjective risk was significantly higher than objective risk. The risk of tumour was overestimated by 56%, and the genetic risk by 67%. The subjects with less cancer affected relatives significantly overestimated their risk of being mutation carriers and made a more innacurate estimation than high risk subjects.

Conclusion

The description of this sample shows: general overestimation of the risk, inaccurate perception compared to BRCApro calculation and a more accurate estimation in those subjects with more cancer affected relatives (high risk subjects). No correlation was found between the levels of perception of risk and anxiety and depression. Based on our findings, it is worth pursuing improved communication strategies about the actual cancer and genetic risk, especially for subjects at "intermediate and slightly increased risk" of developing an hereditary breast and/or ovarian cancer or of being mutation carrier.
Literature
1.
go back to reference Chaliki H, Loader S, Levenkron JC, Logan-Young W, Hall WJ, Rowley PT: Women's receptivity to testing for a genetic susceptibility to breast cancer. Am J Public Health. 1995, 85: 1133-1135. 10.2105/AJPH.85.8_Pt_1.1133.CrossRef Chaliki H, Loader S, Levenkron JC, Logan-Young W, Hall WJ, Rowley PT: Women's receptivity to testing for a genetic susceptibility to breast cancer. Am J Public Health. 1995, 85: 1133-1135. 10.2105/AJPH.85.8_Pt_1.1133.CrossRef
2.
go back to reference Croyle RT, Lerman C: Risk communications in genetic testing for cancer susceptibility. J Natl Cancer Inst. 1999, 25: 59-66.CrossRef Croyle RT, Lerman C: Risk communications in genetic testing for cancer susceptibility. J Natl Cancer Inst. 1999, 25: 59-66.CrossRef
3.
go back to reference Brain K, Gray J, Norman P, Parsons E, Clarke A, Rogers C, Mansel R, Harper P: Why do women attend familial breast cancer clinics?. J Med Genet. 2000, 37: 197-202. 10.1136/jmg.37.3.197.CrossRef Brain K, Gray J, Norman P, Parsons E, Clarke A, Rogers C, Mansel R, Harper P: Why do women attend familial breast cancer clinics?. J Med Genet. 2000, 37: 197-202. 10.1136/jmg.37.3.197.CrossRef
4.
go back to reference Lerman C, Shwartz M: Adherence and psychological adjustment among women at high risk for breast cancer. Breast Cancer Res Treat. 1993, 28: 145-155. 10.1007/BF00666427.CrossRef Lerman C, Shwartz M: Adherence and psychological adjustment among women at high risk for breast cancer. Breast Cancer Res Treat. 1993, 28: 145-155. 10.1007/BF00666427.CrossRef
5.
go back to reference Kash KM, Holland JC, Osbourne MP, Miller DG: Psychological counseling strategies for women at increased risk of breast cancer. J Natl Cancer Inst. 1995, 17: 73-79. Kash KM, Holland JC, Osbourne MP, Miller DG: Psychological counseling strategies for women at increased risk of breast cancer. J Natl Cancer Inst. 1995, 17: 73-79.
6.
go back to reference Watson M, Lloyd S, Davidson J, Meyer L, Eeles R, Ebbs S, Murday V: The impact of genetic counseling on risk perception and mental health in women with a family history of breast cancer. Br J Cancer. 1999, 79: 868-74. 10.1038/sj.bjc.6690139.CrossRef Watson M, Lloyd S, Davidson J, Meyer L, Eeles R, Ebbs S, Murday V: The impact of genetic counseling on risk perception and mental health in women with a family history of breast cancer. Br J Cancer. 1999, 79: 868-74. 10.1038/sj.bjc.6690139.CrossRef
7.
go back to reference Van Oostrom I, Meijers-Heijboer H, Lodder LN, Duivenvoorden HJ, van Gool AR, Seynaeve C, Meer van der CA, Klijn JG, van Geel BN, Burger CW, Wladimiroff JW, Tibben A: Long-term psychological impact of carrying a BRCA1/BRCA2 mutation and prophylactic surgery: A 5-year follow-up study. J Clin Oncol. 2003, 21: 3867-3874. 10.1200/JCO.2003.10.100.CrossRef Van Oostrom I, Meijers-Heijboer H, Lodder LN, Duivenvoorden HJ, van Gool AR, Seynaeve C, Meer van der CA, Klijn JG, van Geel BN, Burger CW, Wladimiroff JW, Tibben A: Long-term psychological impact of carrying a BRCA1/BRCA2 mutation and prophylactic surgery: A 5-year follow-up study. J Clin Oncol. 2003, 21: 3867-3874. 10.1200/JCO.2003.10.100.CrossRef
8.
go back to reference Bradbury AR, Ibe CN, Dignam JJ, Cummings SA, Verp M, White MA, Artioli G, Dudlicek L, Olopade OI: Uptake and timing of bilateral prophylactic salpingo-oophorectomy among BRCA1 and BRCA2 mutation carriers. Genet Med. 2008, 10: 161-6. 10.1097/GIM.0b013e318163487d.CrossRef Bradbury AR, Ibe CN, Dignam JJ, Cummings SA, Verp M, White MA, Artioli G, Dudlicek L, Olopade OI: Uptake and timing of bilateral prophylactic salpingo-oophorectomy among BRCA1 and BRCA2 mutation carriers. Genet Med. 2008, 10: 161-6. 10.1097/GIM.0b013e318163487d.CrossRef
9.
go back to reference Rees G, Fry A, Cull A, Sutton S: Illness perception and distress in women at increased risk of breast cancer. Psychol Health. 2004, 19: 749-765. 10.1080/08870440412331279764.CrossRef Rees G, Fry A, Cull A, Sutton S: Illness perception and distress in women at increased risk of breast cancer. Psychol Health. 2004, 19: 749-765. 10.1080/08870440412331279764.CrossRef
10.
go back to reference Schlich-Bakker KJ, ten Kroode HFJ, Ausems MGEM: A literature review of the psychological impact of genetic testing on breast cancer patients. Patient Educ Couns. 2006, 60: 13-20. 10.1016/j.pec.2005.08.012.CrossRef Schlich-Bakker KJ, ten Kroode HFJ, Ausems MGEM: A literature review of the psychological impact of genetic testing on breast cancer patients. Patient Educ Couns. 2006, 60: 13-20. 10.1016/j.pec.2005.08.012.CrossRef
11.
go back to reference Kelly K, Leventhal H, Marvin M, Toppmeyer D, Much J, Dermody J, Baran J, Schwalb M: Subjective and objective risk of breast cancer in Ashkenazi Jewish individuals at risk for BRCA1/2 mutations. Genet Test. 2004, 8: 139-47.CrossRef Kelly K, Leventhal H, Marvin M, Toppmeyer D, Much J, Dermody J, Baran J, Schwalb M: Subjective and objective risk of breast cancer in Ashkenazi Jewish individuals at risk for BRCA1/2 mutations. Genet Test. 2004, 8: 139-47.CrossRef
12.
go back to reference Kelly KM, Senter L, Leventhal H, Ozakinci G, Porter K: Subjective and objective risk of ovarian cancer in Ashkenazi Jewish women testing for BRCA1/2 mutations. Patient Educ Couns. 2008, 70: 135-142. 10.1016/j.pec.2007.09.007.CrossRef Kelly KM, Senter L, Leventhal H, Ozakinci G, Porter K: Subjective and objective risk of ovarian cancer in Ashkenazi Jewish women testing for BRCA1/2 mutations. Patient Educ Couns. 2008, 70: 135-142. 10.1016/j.pec.2007.09.007.CrossRef
13.
go back to reference D'Agincourt-Canning L: The effect of experimental knowledge on construction of risk perception in hereditary breast/ovarian cancer. J Genet Couns. 2005, 14: 55-69. 10.1007/s10897-005-1500-0.CrossRef D'Agincourt-Canning L: The effect of experimental knowledge on construction of risk perception in hereditary breast/ovarian cancer. J Genet Couns. 2005, 14: 55-69. 10.1007/s10897-005-1500-0.CrossRef
14.
go back to reference Katapodi MC, Lee KA, Facione NC, Dodd MJ: Predictors of perceived breast cancer risk and relation between perceived risk and breast cancer screening: a meta-analytic review. Prev Med. 2004, 39: 388-402. 10.1016/j.ypmed.2003.11.012.CrossRef Katapodi MC, Lee KA, Facione NC, Dodd MJ: Predictors of perceived breast cancer risk and relation between perceived risk and breast cancer screening: a meta-analytic review. Prev Med. 2004, 39: 388-402. 10.1016/j.ypmed.2003.11.012.CrossRef
15.
go back to reference Daly MB, Lerman C, Ross E, Schwartz MD, Sands CB, Masny A: Gail Model breast cancer risk components are poor predictors of risk perception and screening behaviour. Breast Cancer Res Treat. 1996, 41: 59-70. 10.1007/BF01807037.CrossRef Daly MB, Lerman C, Ross E, Schwartz MD, Sands CB, Masny A: Gail Model breast cancer risk components are poor predictors of risk perception and screening behaviour. Breast Cancer Res Treat. 1996, 41: 59-70. 10.1007/BF01807037.CrossRef
16.
go back to reference Walter FM, Emery J, Braithwaite D, Marteau TM: Lay understanding of familial risk of common chronic disease: A systematic review and synthesis of qualitative research. Ann Fam Med. 2004, 2: 583-594. 10.1370/afm.242.CrossRef Walter FM, Emery J, Braithwaite D, Marteau TM: Lay understanding of familial risk of common chronic disease: A systematic review and synthesis of qualitative research. Ann Fam Med. 2004, 2: 583-594. 10.1370/afm.242.CrossRef
17.
go back to reference Quillin JM, McClish DK, Jones RM, Burruss K, Bodurtha JN: Spiritual coping, family history and perceived risk for breast cancer-can we make sense of it?. J Genet Couns. 2006, 15: 449-460. 10.1007/s10897-006-9037-4.CrossRef Quillin JM, McClish DK, Jones RM, Burruss K, Bodurtha JN: Spiritual coping, family history and perceived risk for breast cancer-can we make sense of it?. J Genet Couns. 2006, 15: 449-460. 10.1007/s10897-006-9037-4.CrossRef
18.
go back to reference Gil F, Mendez I, Sirgo A, Llort G, Blanco I, Cortes-Funes L: Perception of breast cancer risk and surveillance behaviours of women with family history of breast cancer: a brief report on a Spanish cohort. Psychooncology. 2003, 12: 821-827. 10.1002/pon.704.CrossRef Gil F, Mendez I, Sirgo A, Llort G, Blanco I, Cortes-Funes L: Perception of breast cancer risk and surveillance behaviours of women with family history of breast cancer: a brief report on a Spanish cohort. Psychooncology. 2003, 12: 821-827. 10.1002/pon.704.CrossRef
19.
go back to reference Caruso A, Vigna C, Maggi G, Sega FM, Cognetti F, Savarese A: The withdrawal from oncogenetic counseling and testing for hereditary and familial breast and ovarian cancer. A descriptive study of an Italian sample. J Exp Clin Cancer Res. 2008, 27: 75-82. 10.1186/1756-9966-27-75.CrossRef Caruso A, Vigna C, Maggi G, Sega FM, Cognetti F, Savarese A: The withdrawal from oncogenetic counseling and testing for hereditary and familial breast and ovarian cancer. A descriptive study of an Italian sample. J Exp Clin Cancer Res. 2008, 27: 75-82. 10.1186/1756-9966-27-75.CrossRef
20.
go back to reference Berry DA, Iversen ES Jr, Gudbjartsson DF, Hiller EH, Garber JE, Peshkin BN, Lerman C, Watson P, Lynch HT, Hilsenbeck SG, Rubinstein WS, Hughes KS, Parmigiani G: BRCAPRO validation, sensitivity of genetic testing of BRCA1/2, and prevalence of other breast cancer susceptibility genes. J Clin Oncol. 2002, 20: 2701-2712. 10.1200/JCO.2002.05.121.CrossRef Berry DA, Iversen ES Jr, Gudbjartsson DF, Hiller EH, Garber JE, Peshkin BN, Lerman C, Watson P, Lynch HT, Hilsenbeck SG, Rubinstein WS, Hughes KS, Parmigiani G: BRCAPRO validation, sensitivity of genetic testing of BRCA1/2, and prevalence of other breast cancer susceptibility genes. J Clin Oncol. 2002, 20: 2701-2712. 10.1200/JCO.2002.05.121.CrossRef
21.
go back to reference Parmigiani G, Berry DA, Aguilar O: Modelling risk of breast cancer and decisions about genetic testing. Am J Hum Genet. 1998, 62: 145-148. 10.1086/301670.CrossRef Parmigiani G, Berry DA, Aguilar O: Modelling risk of breast cancer and decisions about genetic testing. Am J Hum Genet. 1998, 62: 145-148. 10.1086/301670.CrossRef
22.
go back to reference Federico M, Maiorana A, Mangone L, Turchetti D, Canossi B, Cortesi L, Romagnoli R, Silingardi V: Identification of families with hereditary breast and ovarian cancer for clinical and mammographic surveillance: the Modena Study Group proposal. Breast Cancer Res Treat. 1999, 55: 213-221. 10.1023/A:1006192230332.CrossRef Federico M, Maiorana A, Mangone L, Turchetti D, Canossi B, Cortesi L, Romagnoli R, Silingardi V: Identification of families with hereditary breast and ovarian cancer for clinical and mammographic surveillance: the Modena Study Group proposal. Breast Cancer Res Treat. 1999, 55: 213-221. 10.1023/A:1006192230332.CrossRef
23.
go back to reference Cortesi L, Turchetti D, Marchi I, Fracca A, Canossi B, Rachele B, Silvia R, Rita PA, Pietro T, Massimo F: Breast cancer screening in women at increased risk according to different family histories: an update of the Modena Study Group experience. BMC Cancer. 2006, 17: 210-10.1186/1471-2407-6-210.CrossRef Cortesi L, Turchetti D, Marchi I, Fracca A, Canossi B, Rachele B, Silvia R, Rita PA, Pietro T, Massimo F: Breast cancer screening in women at increased risk according to different family histories: an update of the Modena Study Group experience. BMC Cancer. 2006, 17: 210-10.1186/1471-2407-6-210.CrossRef
24.
go back to reference Caruso A, Di Francesco B, Pugliese P, Cinanni V, Corlito A: Information and awareness of diagnosis and progression of cancer in adult and elderly cancer patients Tumori. J Exp Clini Oncology. 2000, 86: 199-203. Caruso A, Di Francesco B, Pugliese P, Cinanni V, Corlito A: Information and awareness of diagnosis and progression of cancer in adult and elderly cancer patients Tumori. J Exp Clini Oncology. 2000, 86: 199-203.
25.
go back to reference Caruso A, Bongiorno L, Vallini I, Russo P, Tomao F, Grandinetti ML: Breast Cancer and Distress Resulting from Magnetic Resonance Imaging (MRI): the impact of a psychological intervention of emotional and informative support. J Exp Clin Cancer Res. 2006, 25: 499-505. Caruso A, Bongiorno L, Vallini I, Russo P, Tomao F, Grandinetti ML: Breast Cancer and Distress Resulting from Magnetic Resonance Imaging (MRI): the impact of a psychological intervention of emotional and informative support. J Exp Clin Cancer Res. 2006, 25: 499-505.
26.
go back to reference Lerman C, Lustbader E, Rimer B: Effects of Individualized Breast Cancer Risk Counseling: a randomized trial. J Natl Cancer Inst. 1995, 87: 286-292. 10.1093/jnci/87.4.286.CrossRef Lerman C, Lustbader E, Rimer B: Effects of Individualized Breast Cancer Risk Counseling: a randomized trial. J Natl Cancer Inst. 1995, 87: 286-292. 10.1093/jnci/87.4.286.CrossRef
27.
go back to reference Ehus D: Cancer Gene Software (Version 4.3) (computer software). 2006, Dallas, TX: UT Southwestern Medical Center at Dallas Ehus D: Cancer Gene Software (Version 4.3) (computer software). 2006, Dallas, TX: UT Southwestern Medical Center at Dallas
28.
go back to reference Berry DA, Parmigiani G, Sanchez J, Schildkraut J, Winer E: Probability of carrying a mutation of breast-ovarian cancer gene BRCA 1 based on family history. J Natl Cancer Inst. 1997, 89: 227-237. 10.1093/jnci/89.3.227.CrossRef Berry DA, Parmigiani G, Sanchez J, Schildkraut J, Winer E: Probability of carrying a mutation of breast-ovarian cancer gene BRCA 1 based on family history. J Natl Cancer Inst. 1997, 89: 227-237. 10.1093/jnci/89.3.227.CrossRef
29.
go back to reference Frank TS, Manley SA, Olopade OI, Cummings S, Garber JE, Bernhardt B, Antman K, Russo D, Wood ME, Mullineau L, Isaacs C, Peshkin B, Buys S, Venne V, Rowley PT, Loader S, Offit K, Robson M, Hampel H, Brener D, Winer EP, Clark S, Weber B, Strong LC, Thomas A: Sequence analysis of BRCA1 and BRCA2: correlations of mutations with family history and ovarian cancer risk. J Clin Oncol. 1998, 16: 2417-2425. Frank TS, Manley SA, Olopade OI, Cummings S, Garber JE, Bernhardt B, Antman K, Russo D, Wood ME, Mullineau L, Isaacs C, Peshkin B, Buys S, Venne V, Rowley PT, Loader S, Offit K, Robson M, Hampel H, Brener D, Winer EP, Clark S, Weber B, Strong LC, Thomas A: Sequence analysis of BRCA1 and BRCA2: correlations of mutations with family history and ovarian cancer risk. J Clin Oncol. 1998, 16: 2417-2425.
30.
go back to reference Couch FJ, Farid LM, DeShano ML, Tavtigian SV, Calzone K, Campeau L, Peng Y, Bogden B, Chen Q, Neuhausen S, Shattuck-Eidens D, Godwin AK, Daly M, Radford DM, Sedlacek S, Rommens J, Simard J, Garber J, Merajver S, Weber BL: BRCA 2 germ-line mutations in male breast cancer cases and breast cancer families. Nat Genet. 1996, 13: 123-125. 10.1038/ng0596-123.CrossRef Couch FJ, Farid LM, DeShano ML, Tavtigian SV, Calzone K, Campeau L, Peng Y, Bogden B, Chen Q, Neuhausen S, Shattuck-Eidens D, Godwin AK, Daly M, Radford DM, Sedlacek S, Rommens J, Simard J, Garber J, Merajver S, Weber BL: BRCA 2 germ-line mutations in male breast cancer cases and breast cancer families. Nat Genet. 1996, 13: 123-125. 10.1038/ng0596-123.CrossRef
31.
go back to reference Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983, 67: 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRef Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983, 67: 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRef
32.
go back to reference Costantini M, Musso M, Viterbori P, Bonci F, Del Mastro L, Garrone O, Venturini M, Morasso G: Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer. 1999, 7: 121-127. 10.1007/s005200050241.CrossRef Costantini M, Musso M, Viterbori P, Bonci F, Del Mastro L, Garrone O, Venturini M, Morasso G: Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer. 1999, 7: 121-127. 10.1007/s005200050241.CrossRef
33.
go back to reference Bluman LG, Rimer BK, Berry DA, Borstelmann N, Iglehart JD, Regan K, Schildkraut J, Winer EP: Attitudes knowledge, and risk perceptions of women with breast and/or ovarian cancer considering testing for BRCA1 and BRCA2. J Clin Oncol. 1999, 17: 1999-104. Bluman LG, Rimer BK, Berry DA, Borstelmann N, Iglehart JD, Regan K, Schildkraut J, Winer EP: Attitudes knowledge, and risk perceptions of women with breast and/or ovarian cancer considering testing for BRCA1 and BRCA2. J Clin Oncol. 1999, 17: 1999-104.
34.
go back to reference Cohen J: A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960, 20: 37-46. 10.1177/001316446002000104.CrossRef Cohen J: A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960, 20: 37-46. 10.1177/001316446002000104.CrossRef
35.
go back to reference Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics. 1977, 33: 159-174. 10.2307/2529310.CrossRef Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics. 1977, 33: 159-174. 10.2307/2529310.CrossRef
36.
go back to reference Foster C, Evans DG, Eeles R, Eccles D, Ashley S, Brooks L, Davidson R, Mackay J, Morrison PJ, Watson M: Predictive testing for BRCA 1/2: attributes, risk perception and management in a multi-centre clinical cohort. Br J Cancer. 2002, 86: 1209-1216. 10.1038/sj.bjc.6600253.CrossRef Foster C, Evans DG, Eeles R, Eccles D, Ashley S, Brooks L, Davidson R, Mackay J, Morrison PJ, Watson M: Predictive testing for BRCA 1/2: attributes, risk perception and management in a multi-centre clinical cohort. Br J Cancer. 2002, 86: 1209-1216. 10.1038/sj.bjc.6600253.CrossRef
37.
go back to reference Meiser B, Butow PN, Barratt AL, Schnieden V, Gattas M, Kirk J, Gaff C, Suthers G, Tucker K, Psychological Impact Collaborative Group: Psychological Impact Collaborative Group. Long-term outcomes of genetic counseling in women at increased risk of developing hereditary breast cancer. Patient Educ Couns. 2001, 44: 215-225. 10.1016/S0738-3991(00)00191-9.CrossRef Meiser B, Butow PN, Barratt AL, Schnieden V, Gattas M, Kirk J, Gaff C, Suthers G, Tucker K, Psychological Impact Collaborative Group: Psychological Impact Collaborative Group. Long-term outcomes of genetic counseling in women at increased risk of developing hereditary breast cancer. Patient Educ Couns. 2001, 44: 215-225. 10.1016/S0738-3991(00)00191-9.CrossRef
38.
go back to reference Evans DG, Burnell LD, Hopwood P, Howell A: Perception of risk in women with a family history of breast cancer. Br J Cancer. 1993, 67: 612-614.CrossRef Evans DG, Burnell LD, Hopwood P, Howell A: Perception of risk in women with a family history of breast cancer. Br J Cancer. 1993, 67: 612-614.CrossRef
39.
go back to reference Heshka JT, Palleschi C, Howley H, Wilson B, Wells PS: A systematic review of perceived risk, psychological and behavioural impacts of genetic testing. Genet Med. 2008, 10: 19-32. 10.1097/GIM.0b013e31815f524f.CrossRef Heshka JT, Palleschi C, Howley H, Wilson B, Wells PS: A systematic review of perceived risk, psychological and behavioural impacts of genetic testing. Genet Med. 2008, 10: 19-32. 10.1097/GIM.0b013e31815f524f.CrossRef
40.
go back to reference Condello C, Gesuita R, Pensabene M, Spagnoletti I, Capuano I, Baldi C, Carle F, Contegiacomo A: Distress and family functioning in oncogenetic counseling for hereditary and familial breast and/or ovarian cancers. J Genet Couns. 2007, 16: 625-634. 10.1007/s10897-007-9102-7.CrossRef Condello C, Gesuita R, Pensabene M, Spagnoletti I, Capuano I, Baldi C, Carle F, Contegiacomo A: Distress and family functioning in oncogenetic counseling for hereditary and familial breast and/or ovarian cancers. J Genet Couns. 2007, 16: 625-634. 10.1007/s10897-007-9102-7.CrossRef
41.
go back to reference Lerman C, Trock B, Rimer BK, Jepson C, Brody D, Boyce A: Psychological side effects of breast cancer screening. Health Psychol. 1991, 10: 259-67. 10.1037/0278-6133.10.4.259.CrossRef Lerman C, Trock B, Rimer BK, Jepson C, Brody D, Boyce A: Psychological side effects of breast cancer screening. Health Psychol. 1991, 10: 259-67. 10.1037/0278-6133.10.4.259.CrossRef
Metadata
Title
Subjective versus objective risk in genetic counseling for hereditary breast and/or ovarian cancers
Authors
Anita Caruso
Cristina Vigna
Bruna Marozzo
Fabio M Sega
Isabella Sperduti
Francesco Cognetti
Antonella Savarese
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Experimental & Clinical Cancer Research / Issue 1/2009
Electronic ISSN: 1756-9966
DOI
https://doi.org/10.1186/1756-9966-28-157

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