Better Counseling Facilitates Decision Making After Testing


NEW YORK — Enhanced counseling can help women at high risk of breast or ovarian cancer make better use of the information they receive from genetic testing for BRCA1 and BRCA2 mutations, according to a study presented in poster form at a cancer symposium sponsored by New York University.

The few studies that have examined the effects of genetic testing on decision making have found that a significant proportion of eligible women don't take any action after learning their genetic status, according to Suzanne Miller, Ph.D., of Fox Chase Cancer Center in Philadelphia, and her associates.

The investigators randomized approximately half of the study's 80 women who were at high risk for ovarian cancer based on family history to receive “enhanced counseling” before genetic testing.

This process was aimed at helping the women “prelive” how they might respond to their test results.

“We wanted to help women anticipate how they would react, so they would be prepared for it,” Dr. Miller, the study's lead investigator, said during an interview.

Six months later, 68% of the women in the intervention group had sought prophylactic oophorectomy information, and 28% had undergone the surgery. In the control group, which had received standard counseling along with information about improving their general health, 26% had sought information on oophorectomy and 6% had had the surgery.

“The women in the intervention arm were in a position to take action when they got their results,” Dr. Miller said. “This indicates that enhanced counseling can play an important role in decision-making after BRCA1 and2 testing.”

The symposium was also sponsored by the Lynne Cohen Foundation for Ovarian Cancer Research.

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