Genetic clinicians' confidence in BOADICEA comprehensive breast cancer risk estimates and counselees' psychosocial outcomes: A prospective study.


Journal

Clinical genetics
ISSN: 1399-0004
Titre abrégé: Clin Genet
Pays: Denmark
ID NLM: 0253664

Informations de publication

Date de publication:
07 2022
Historique:
revised: 27 04 2022
received: 22 02 2022
accepted: 01 05 2022
pubmed: 5 5 2022
medline: 16 6 2022
entrez: 4 5 2022
Statut: ppublish

Résumé

Counseling for familial breast cancer focuses on communicating the gene test result (GENE) to counselees, but risk prediction models have become more complex by including non-genetic risk factors (NGRF) and polygenic risk scores (PRS). We examined genetic clinicians' confidence in counseling and counselees' psychosocial outcomes, using the BOADICEA risk prediction tool with different categories of risk factors as input. A prospective observational study in Dutch, French and German genetic clinics was performed including 22 clinicians, and 406 of 460 (88.3%) eligible cancer-unaffected women at high breast cancer risk assessed at pre-test and 350 (76.1%) at post-test. We performed multilevel analyses accounting for the clinician, and counselees' characteristics. Overall, risk estimates category by GENE versus GENE+ NGRF, or GENE+NGRF+PRS differed in 11% and 25% of counselees, respectively. In multilevel analyses, clinicians felt less confident in counseling when the full model provided lower breast cancer risks than GENE (i.e., in 8% of cases). Older counselees expressed higher breast cancer risk perception and worries about the hereditary predisposition when the full model provided higher breast cancer risks than GENE only. Genetic clinicians appear confident with breast cancer risk comprehensive models, which seem only to affect perceptions of older counselees.

Identifiants

pubmed: 35508697
doi: 10.1111/cge.14147
pmc: PMC9322298
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

30-39

Informations de copyright

© 2022 The Authors. Clinical Genetics published by John Wiley & Sons Ltd.

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Auteurs

Anne Brédart (A)

Institut Curie, Supportive Care Department, Psycho-oncology Unit, PSL University, Paris, France.
Psychology Institute, Psychopathology and Health Process Laboratory, University of Paris, Boulogne-Billancourt, France.

Antoine De Pauw (A)

Institut Curie, Cancer genetic clinic, PSL University, University of Paris, Paris Cedex 05, France.

Anja Tüchler (A)

Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany.

Inge M M Lakeman (IMM)

Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands.

Amélie Anota (A)

Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France.
Human and Social Sciences Department, Centre Léon Bérard, Lyon, France.
French National Platform Quality of Life and Cancer, Centre Léon Bérard, Lyon, France.

Kerstin Rhiem (K)

Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany.

Rita Schmutzler (R)

Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany.

Christi J van Asperen (CJ)

Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands.

Peter Devilee (P)

Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands.
Department of Pathology, Leiden University Medical Centre, Leiden, The Netherlands.

Dominique Stoppa-Lyonnet (D)

Institut Curie, Cancer genetic clinic, PSL University, University of Paris, Paris Cedex 05, France.

Jean-Luc Kop (JL)

2LPN, Université de Lorraine, Nancy, France.

Sylvie Dolbeault (S)

Institut Curie, Supportive Care Department, Psycho-oncology Unit, PSL University, Paris, France.
CESP, University Paris-Sud, UVSQ, INSERM, University Paris-Saclay, Villejuif Cedex, France.

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