Paper in Journal of Clinical Oncology
  • Dawson S-J, Price MA, Jenkins MA, McKinley JM, Butow PN, McLachlan S-A, Lindeman GJ, Weideman P, kConFab Investigators, Friedlander ML, Hopper JL, Phillips K-A. (2008) Cancer risk management practices of non-carriers within BRCA1/2 mutation positive families in the Kathleen Cuningham Consortium for Research into Familial Breast Cancer (kConFab). Journal of Clinical Oncology, 26: 225-232.

    ABSTRACT

    Purpose Women from BRCA mutation-positive families who do not carry the family-specific mutation are generally at average cancer risk and therefore do not require intensive risk management.

    Methods Participants were female noncarriers from BRCA mutation-positive families who had responded to 3 yearly follow-up questionnaires and had chosen to either receive or not receive their genetic test result. In the former group, undertaking mammography younger than age 40 years or more than once every 2 years, clinical breast examination (CBE) more than yearly, breast selfexamination (BSE) more than monthly, or any transvaginal ultrasound (TVU) or CA-125 was considered overscreening. Screening behaviors of women who did and did not know their genetic test result were compared. Logistic regression and nonparametric analyses were performed to identify demographic and psychosocial factors (respectively) associated with overscreening.

    Results Of 325 eligible women, 116 knew their mutation status and 209 did not. For the first group, proportions overscreening were mammography, 53%; CBE, 10%; BSE, 11%; TVU, 7%; and CA-125, 10%. There were no significant differences in screening behaviors between the groups. In those aware of their mutation status, parous women were more likely to overuse mammography (odds ratio [OR] = 4.4; 95% CI, 1.1 to 17; P = .03) and women with one or more first-degree relative with ovarian cancer (OC) were more likely to overuse OC screening (TVU: OR = 6.00; 95% CI, 1.0 to 35.1; P = .047, and CA-125: OR = 6.50; 95% CI, 1.49 to 28.4; P = .013).

    Conclusion The reasons for overuse of screening (particularly mammography) by mutation noncarriers require additional elucidation given the potential for harm.