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Int. J. Environ. Res. Public Health 2018, 15(2), 319; https://doi.org/10.3390/ijerph15020319

Patient-Centered Care in Breast Cancer Genetic Clinics

1
Supportive Care Department, Psycho-Oncology Unit, Institut Curie, 26 Rue d’Ulm, 75005 Paris CEDEX 05, France
2
Psychopathology and Health Process Laboratory, University Paris Descartes, EA 4057, 71 Avenue Edouard Vaillant, 92774 Boulogne-Billancourt, France
3
Quality of Life and Cancer Clinical Research Platform, Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), CHU Besançon, 25030 Besançon, France
4
Familial Breast and Ovarian Cancer Centre, Cologne University Hospital and Faculty of Medicine, Kerpener Str. 34, 50931 Cologne, Germany
5
Cancer Genetic Clinic, Institut Curie, 26 Rue d’Ulm, 75005 Paris CEDEX 05, France
6
Clinical and Health Psychology Department, University Autónoma of Barcelona, Carrer de Ca N’Altayó, s/n, 08193 Barcelona, Spain
7
Centre de Recherche en Épidémiologie et Santé des Populations (CESP), University Paris-Sud, UVSQ, INSERM, University Paris-Saclay, 16 Avenue Paul Vaillant-Couturier, 94807 Villejuif CEDEX, France
8
Department 2LPN-CEMA, Université de Lorraine, 23 boulevard Albert 1er - BP 60446 - 54001 NANCY CEDEX, France
*
Author to whom correspondence should be addressed.
Received: 21 December 2017 / Revised: 1 February 2018 / Accepted: 7 February 2018 / Published: 12 February 2018
(This article belongs to the Special Issue Quality of Patient-Centered Care)
Full-Text   |   PDF [348 KB, uploaded 12 February 2018]

Abstract

With advances in breast cancer (BC) gene panel testing, risk counseling has become increasingly complex, potentially leading to unmet psychosocial needs. We assessed psychosocial needs and correlates in women initiating testing for high genetic BC risk in clinics in France and Germany, and compared these results with data from a literature review. Among the 442 counselees consecutively approached, 212 (83%) in France and 180 (97%) in Germany, mostly BC patients (81% and 92%, respectively), returned the ‘Psychosocial Assessment in Hereditary Cancer’ questionnaire. Based on the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) BC risk estimation model, the mean BC lifetime risk estimates were 19% and 18% in France and Germany, respectively. In both countries, the most prevalent needs clustered around the “living with cancer” and “children-related issues” domains. In multivariate analyses, a higher number of psychosocial needs were significantly associated with younger age (b = −0.05), higher anxiety (b = 0.78), and having children (b = 1.51), but not with country, educational level, marital status, depression, or loss of a family member due to hereditary cancer. These results are in line with the literature review data. However, this review identified only seven studies that quantitatively addressed psychosocial needs in the BC genetic counseling setting. Current data lack understandings of how cancer risk counseling affects psychosocial needs, and improves patient-centered care in that setting. View Full-Text
Keywords: breast cancer; genetic risk; risk counseling; psychosocial needs; distress; service delivery; culture breast cancer; genetic risk; risk counseling; psychosocial needs; distress; service delivery; culture
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Brédart, A.; Anota, A.; Dick, J.; Kuboth, V.; Lareyre, O.; De Pauw, A.; Cano, A.; Stoppa-Lyonnet, D.; Schmutzler, R.; Dolbeault, S.; Kop, J.-L. Patient-Centered Care in Breast Cancer Genetic Clinics. Int. J. Environ. Res. Public Health 2018, 15, 319.

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