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Article

Genetic Testing and Surveillance of Young Breast Cancer Survivors and Blood Relatives: A Cluster Randomized Trial

1
Department of Clinical Research, Faculty of Medicine, University of Basel, 4055 Basel, Switzerland
2
School of Nursing, University of Michigan, Ann Arbor, MI 48109-5482, USA
3
College of Nursing, Ohio State University, Columbus, OH 43210, USA
4
Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
5
Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109-5618, USA
6
School of Public Health, University of Michigan, Ann Arbor, MI 48109-5618, USA
7
Statistics Online Computational Resource, School of Nursing, University of Michigan, Ann Arbor, MI 48109-2003, USA
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(9), 2526; https://doi.org/10.3390/cancers12092526
Received: 2 August 2020 / Revised: 2 September 2020 / Accepted: 3 September 2020 / Published: 5 September 2020
Identifying breast cancer patients with pathogenic mutations that run in their families may improve the follow-up care they receive and breast cancer screening of their close relatives. In this study we identified breast cancer patients with high chances of having a pathogenic mutation and their close female relatives. We developed and tested two different kinds of letters and booklets that presented either personalized or generic information about screening and breast cancer that runs in families, and we encouraged participants to seek genetic evaluation. We found that both types of letters worked equally well for breast cancer patients and for relatives, regardless of their racial background. The personalized letters had slightly better outcomes. Some breast cancer patients and their relatives used genetic services and improved their screening practices. Black patients and their relatives were more satisfied with the booklets than other participants.
We compared a tailored and a targeted intervention designed to increase genetic testing, clinical breast exam (CBE), and mammography in young breast cancer survivors (YBCS) (diagnosed <45 years old) and their blood relatives. A two-arm cluster randomized trial recruited a random sample of YBCS from the Michigan cancer registry and up to two of their blood relatives. Participants were stratified according to race and randomly assigned as family units to the tailored (n = 637) or the targeted (n = 595) intervention. Approximately 40% of participants were Black. Based on intention-to-treat analyses, YBCS in the tailored arm reported higher self-efficacy for genetic services (p = 0.0205) at 8-months follow-up. Genetic testing increased approximately 5% for YBCS in the tailored and the targeted arm (p ≤ 0.001; p < 0.001) and for Black and White/Other YBCS (p < 0.001; p < 0.001). CBEs and mammograms increased significantly in both arms, 5% for YBCS and 10% for relatives and were similar for Blacks and White/Others. YBCS and relatives needing less support from providers reported significantly higher self-efficacy and intention for genetic testing and surveillance. Black participants reported significantly higher satisfaction and acceptability. Effects of these two low-resource interventions were comparable to previous studies. Materials are suitable for Black women at risk for hereditary breast/ovarian cancer (HBOC). View Full-Text
Keywords: HBOC; statewide random sampling; cancer survivorship; targeted intervention; tailored intervention; Black participants; family recruitment; cascade genetic testing in families HBOC; statewide random sampling; cancer survivorship; targeted intervention; tailored intervention; Black participants; family recruitment; cascade genetic testing in families
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MDPI and ACS Style

Katapodi, M.C.; Ming, C.; Northouse, L.L.; Duffy, S.A.; Duquette, D.; Mendelsohn-Victor, K.E.; Milliron, K.J.; Merajver, S.D.; Dinov, I.D.; Janz, N.K. Genetic Testing and Surveillance of Young Breast Cancer Survivors and Blood Relatives: A Cluster Randomized Trial. Cancers 2020, 12, 2526. https://doi.org/10.3390/cancers12092526

AMA Style

Katapodi MC, Ming C, Northouse LL, Duffy SA, Duquette D, Mendelsohn-Victor KE, Milliron KJ, Merajver SD, Dinov ID, Janz NK. Genetic Testing and Surveillance of Young Breast Cancer Survivors and Blood Relatives: A Cluster Randomized Trial. Cancers. 2020; 12(9):2526. https://doi.org/10.3390/cancers12092526

Chicago/Turabian Style

Katapodi, Maria C., Chang Ming, Laurel L. Northouse, Sonia A. Duffy, Debra Duquette, Kari E. Mendelsohn-Victor, Kara J. Milliron, Sofia D. Merajver, Ivo D. Dinov, and Nancy K. Janz 2020. "Genetic Testing and Surveillance of Young Breast Cancer Survivors and Blood Relatives: A Cluster Randomized Trial" Cancers 12, no. 9: 2526. https://doi.org/10.3390/cancers12092526

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