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abstract:
Psychosocial Adjustment and Perceived Risk Among Adolescent Girls From Families With BRCA1/2 or Breast Cancer History
Purpose To evaluate the impact of breast cancer family history and maternal BRCA1/2 mutation on the psychosocial adjustment and perceived risk in girls age 11 to 19 years old.
Materials and Methods Girls age 11 to 19 years old with one or more relatives with breast cancer or a familial BRCA1/2 mutation (breast cancer family history [BCFH] positive, n = 208; n = 69 with BRCA1/2-positive mother), peers (BCFH negative, n = 112), and their mothers completed assessments of psychosocial adjustment, breast
cancer–specific distress, and perceived risk of breast cancer.
Results General
psychosocial adjustment did not differ significantly between
BCFH-positive and BCFH-negative girls, either by self-report
or mother report, except for higher self-esteem
among BCFH-positive girls (P = .01). BCFH-positive girls had higher breast cancer–specific distress than BCFH-negative girls (P < .001), but girls from BRCA1/2-positive families did not differ from other BCFH-positive peers. BCFH-positive girls were more likely to report themselves
at increased self-risk for breast cancer in adulthood than BCFH-negative peers (74% v 33%, respectively; P ≤ .001). Girls from BRCA1/2-positive families were more likely than other BCFH-positive and BCFH-negative peers to report themselves at increased risk
(P < .001). In all groups, perceived
risk of breast cancer was associated with older age. Higher breast
cancer–specific distress
among adolescent girls was associated with
higher self-perceived risk of breast cancer and higher maternal breast
cancer–specific
distress.
Conclusion Adolescent girls from BRCA1/2-positive
and breast cancer families have higher self-esteem and do not have
poorer psychosocial adjustment than peers. However,
they do experience greater breast
cancer–specific distress and perceived risk of breast cancer,
particularly among older girls.
Understanding the impact is important to
optimize responses to growing up in families at familial and genetic
risk for breast
cancer, particularly given the debate over the
genetic testing of children for cancer susceptibility in adulthood.
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