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Cancer Control Research

Abstract

This project will evaluate different strategies for counseling female relatives of women with breast cancer. Potential subjects will be identified during a follow-up study of a population-based cohort of women diagnosed with breast cancer at age 45 or younger. Relatives of these probands will be offered the opportunity to participate in the counseling study. Based on an initial pedigree analysis, women from high-risk families (meeting criteria for autosomal dominant predisposition to breast cancer) will be offered genetic counseling and information regarding options for DNA testing to further evaluate inherited risk for breast cancer. We anticipate that we will identify 10-15 high-risk families in this study. Subjects not meeting the high-risk criteria will be randomized to one of four arms: (1) Genetic counseling: (2) Group education and counseling: (3) Counseling by their primary care provider, based on risk information provided by the study; and (4) A comparison group who will be provided only with informational materials about breast cancer risk and prevention. A total of 100 subjects will be enrolled in each arm. Counseling provided will include information on genetic and non-genetic risk factors for breast cancer, current recommendations for prevention and screening, and information on the potential role in the future of DNA-based testing for mutations associated with breast cancer risk. Subjects randomized to the primary care counseling and comparison groups will be offered the opportunity for genetic counseling after a 1- year follow-up period and data collection have been completed. Subjects will be surveyed before, immediately after and one year following counseling, to assess risk perception, degree of psychological distress related to breast cancer. breast cancer screening practices, understanding of genetic risks for breast cancer and interest in genetic testing, and interest in genetic testing. Follow-up of subjects from the high-risk families will include use of genetic testing and the psychological effects and preventive behaviors occurring after testing.