Attitudes and psychological impact of genetic testing, genetic counseling, and breast cancer risk assessment among women at increased risk.

Abstract

PURPOSE/OBJECTIVES: To review research related to the psychological functioning of women with family histories of breast cancer, the impact of genetic counseling on women at increased risk, and their participation in and description of breast cancer risk evaluation programs. DATA SOURCES: Published articles and material from the World Wide Web. DATA SYNTHESIS: Findings from these sources suggest an underlying level of psychological distress in women with family histories of breast cancer. This may either increase or decrease their surveillance practices. With the onset of commercial genetic testing for BRCA1 and BRCA2, researchers have studied some of the initial psychosocial effects of genetic information on women at high risk. CONCLUSIONS: Women with family histories of breast cancer have a very high interest in genetic testing for BRCA1 and BRCA2 mutations. They have an underlying level of psychological distress that is not relieved by genetic counseling. They tend to state reasons for wanting and not wanting testing that are not polar opposites. Women who attend breast cancer risk assessment programs tend to be self-referred, Caucasian, well-educated, and of middle or upper income status. Large gaps exist in the research on women of color and those who are less educated and of lower socioeconomic status. IMPLICATIONS FOR NURSING: Nurses and other healthcare professionals should tailor care given to women at increased risk for hereditary breast cancer by using the current information related to their emotional and medical needs. Decisions regarding genetic testing, genetic counseling, and breast cancer risk assessment are highly individualized. Thus, healthcare professionals should be cautious regarding any generalizations about women at risk for breast cancer.