Effect of decision aid for breast cancer prevention on decisional conflict in women with a BRCA1 or BRCA2 mutation: a multisite, randomized, controlled trial

Genet Med. 2017 Mar;19(3):330-336. doi: 10.1038/gim.2016.108. Epub 2016 Sep 1.

Abstract

Purpose: Women with a BRCA1 or BRCA2 mutation are at high risk for breast cancer and must make important decisions about breast cancer prevention and screening. In the current study, we report a multisite, randomized, controlled trial evaluating the effectiveness of a decision aid for breast cancer prevention in women with a BRCA mutation with no previous diagnosis of cancer.

Methods: Within 1 month of receiving a positive BRCA result, women were randomized to receive either usual care (control group) or decision aid (intervention group). Participants were followed at 3, 6, and 12 months; were asked about preventive measures; and completed standardized questionnaires assessing decision making and psychosocial functioning.

Results: One hundred fifty women were randomized. Mean cancer-related distress scores were significantly lower in the intervention group compared with the control group at 6 months (P = 0.01) and at 12 months postrandomization (P = 0.05). Decisional conflict scores declined over time for both groups and at no time were there statistical differences between the two groups.

Conclusion: The decision aid for breast cancer prevention in women with a BRCA1 or BRCA2 mutation is effective in significantly decreasing cancer-related distress within the year following receipt of positive genetic test results.Genet Med 19 3, 330-336.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • BRCA1 Protein / genetics
  • Breast Neoplasms / genetics
  • Breast Neoplasms / prevention & control*
  • Breast Neoplasms / psychology
  • Decision Making / ethics
  • Decision Support Techniques*
  • Female
  • Genes, BRCA1
  • Genes, BRCA2
  • Genetic Counseling / psychology
  • Genetic Testing
  • Humans
  • Middle Aged
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • BRCA1 Protein
  • BRCA1 protein, human