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Campacci N, de Campos Reis Galvão H, Garcia LF, Ribeiro PC, Grasel RS, Goldim JR, Ashton-Prolla P, Palmero EI. Genetic cancer risk assessment: A screenshot of the psychosocial profile of women at risk for hereditary breast and ovarian cancer syndrome. Psychooncology 2020; 29:681-687. [PMID: 31984583 DOI: 10.1002/pon.5305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/21/2019] [Accepted: 11/21/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE There is a lack of information describing Brazilian women at risk of hereditary breast and ovarian cancer syndrome (HBOC) who undergo genetic cancer risk assessment (GCRA). This study aims to characterize the psychosocial profile of women at risk for HBOC at their first GCRA to obtain an overview of their families' profiles and the challenges of the oncogenetics setting. METHODS This was a cross-sectional study in which interviews were conducted with 83 cancer-affected women at their first GRCA appointment after the pedigree draw. Tools to evaluate psychological outcomes were applied. The pedigree genogram and ecomap were constructed and analyzed with content analysis using the "life course perspective" theory. RESULTS Individuals perceived their breast/ovarian cancer risk to be equal to that of the general population, although they were highly concerned about developing cancer. No evidence of anxiety or depressive symptoms was identified. Participants used the coping strategy of searching for religiosity. The genograms and ecomaps resulted in five major themes: support and social support; attitudes, feelings and emotions; cancer causes; communication; and relationships with relatives. Individuals between 20-29 years of age and those with no family history of cancer tended not to communicate with relatives, which may indicate future problems in the GCRA process regarding genetic testing. CONCLUSIONS This study demonstrated that knowing the families who undergo the GCRA process can help professionals provide more individualized and thorough attention during GCRA and genetic testing, which results in better follow-up and prevention strategies.
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Affiliation(s)
- Natalia Campacci
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Lucas F Garcia
- Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário Cesumar, Maringá, Brazil
| | - Paula C Ribeiro
- Oncogenetics Department, Barretos Cancer Hospital, Barretos, Brazil
| | - Rebeca S Grasel
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | - José R Goldim
- Programa de Pós-Graduação em Genéticae Biologia Molecular (PPGBM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Patrícia Ashton-Prolla
- Programa de Pós-Graduação em Genéticae Biologia Molecular (PPGBM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Laboratório de Medicina Genômica, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Edenir I Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.,Programa de Pós-Graduação em Genéticae Biologia Molecular (PPGBM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Barretos School of Health Sciences, Dr. Paulo Prata - FACISB, Sao Paolo, Brazil
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Palmero EI, Alemar B, Schüler-Faccini L, Hainaut P, Moreira-Filho CA, Ewald IP, dos Santos PK, Ribeiro PLI, de Oliveira CB, Kelm FLC, Tavtigian S, Cossio SL, Giugliani R, Caleffi M, Ashton-Prolla P. Screening for germline BRCA1, BRCA2, TP53 and CHEK2 mutations in families at-risk for hereditary breast cancer identified in a population-based study from Southern Brazil. Genet Mol Biol 2016; 39:210-22. [PMID: 27223485 PMCID: PMC4910552 DOI: 10.1590/1678-4685-gmb-2014-0363] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 11/24/2015] [Indexed: 01/22/2023] Open
Abstract
In Brazil, breast cancer is a public health care problem due to its high incidence and mortality rates. In this study, we investigated the prevalence of hereditary breast cancer syndromes (HBCS) in a population-based cohort in Brazils southernmost capital, Porto Alegre. All participants answered a questionnaire about family history (FH) of breast, ovarian and colorectal cancer and those with a positive FH were invited for genetic cancer risk assessment (GCRA). If pedigree analysis was suggestive of HBCS, genetic testing of the BRCA1, BRCA2, TP53, and CHEK2 genes was offered. Of 902 women submitted to GCRA, 214 had pedigrees suggestive of HBCS. Fifty of them underwent genetic testing: 18 and 40 for BRCA1/BRCA2 and TP53 mutation screening, respectively, and 7 for CHEK2 1100delC testing. A deleterious BRCA2 mutation was identified in one of the HBOC probands and the CHEK2 1100delC mutation occurred in one of the HBCC families. No deleterious germline alterations were identified in BRCA1 or TP53. Although strict inclusion criteria and a comprehensive testing approach were used, the suspected genetic risk in these families remains unexplained. Further studies in a larger cohort are necessary to better understand the genetic component of hereditary breast cancer in Southern Brazil.
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Affiliation(s)
- Edenir Inêz Palmero
- Programa de Pós Graduação em Genética e Biologia Molecular,
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Laboratório de Medicina Genômica, Hospital de Clinicas de Porto
Alegre, Porto Alegre, RS, Brazil
- Cluster of Molecular Carcinogenesis, International Agency for
Research on Cancer, Lyon, France
- Centro de Pesquisa em Oncologia Molecular, Hospital de Câncer de
Barretos, Barretos, SP, Brazil
- Faculdade de Ciências da Saúde Dr. Paulo Prata, São Paulo, SP,
Brazil
| | - Bárbara Alemar
- Programa de Pós Graduação em Genética e Biologia Molecular,
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Laboratório de Medicina Genômica, Hospital de Clinicas de Porto
Alegre, Porto Alegre, RS, Brazil
| | - Lavínia Schüler-Faccini
- Programa de Pós Graduação em Genética e Biologia Molecular,
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Serviço de Genética Médica, Hospital de Clinicas de Porto Alegre,
Porto Alegre, RS, Brazil
- Departmento de Genética, Universidade Federal do Rio Grande do Sul,
Porto Alegre, RS, Brazil
| | - Pierre Hainaut
- Cluster of Molecular Carcinogenesis, International Agency for
Research on Cancer, Lyon, France
| | - Carlos Alberto Moreira-Filho
- Centro de Pesquisa Experimental, Instituto de Educação e Pesquisa
Albert Einstein, São Paulo, SP, Brazil
- Departmento de Imunologia, Instituto de Ciências Biomédicas,
Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ingrid Petroni Ewald
- Laboratório de Medicina Genômica, Hospital de Clinicas de Porto
Alegre, Porto Alegre, RS, Brazil
| | - Patricia Koehler dos Santos
- Programa de Pós Graduação em Genética e Biologia Molecular,
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Laboratório de Medicina Genômica, Hospital de Clinicas de Porto
Alegre, Porto Alegre, RS, Brazil
| | | | | | - Florence Le Calvez Kelm
- Cluster of Molecular Carcinogenesis, International Agency for
Research on Cancer, Lyon, France
| | - Sean Tavtigian
- Cluster of Molecular Carcinogenesis, International Agency for
Research on Cancer, Lyon, France
| | - Silvia Liliana Cossio
- Laboratório de Medicina Genômica, Hospital de Clinicas de Porto
Alegre, Porto Alegre, RS, Brazil
- Programa de Pós Graduação em Gastroenterologia, Universidade Federal
do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Programa de Pós Graduação em Genética e Biologia Molecular,
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Serviço de Genética Médica, Hospital de Clinicas de Porto Alegre,
Porto Alegre, RS, Brazil
- Departmento de Genética, Universidade Federal do Rio Grande do Sul,
Porto Alegre, RS, Brazil
| | - Maira Caleffi
- Nucleo Mama Porto Alegre e Associação Hospitalar Moinhos de Vento,
Porto Alegre, RS, Brazil
| | - Patricia Ashton-Prolla
- Programa de Pós Graduação em Genética e Biologia Molecular,
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Laboratório de Medicina Genômica, Hospital de Clinicas de Porto
Alegre, Porto Alegre, RS, Brazil
- Serviço de Genética Médica, Hospital de Clinicas de Porto Alegre,
Porto Alegre, RS, Brazil
- Departmento de Genética, Universidade Federal do Rio Grande do Sul,
Porto Alegre, RS, Brazil
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Weitzel JN, Blazer KR, MacDonald DJ, Culver JO, Offit K. Genetics, genomics, and cancer risk assessment: State of the Art and Future Directions in the Era of Personalized Medicine. CA Cancer J Clin 2011; 61:327-59. [PMID: 21858794 PMCID: PMC3346864 DOI: 10.3322/caac.20128] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Scientific and technologic advances are revolutionizing our approach to genetic cancer risk assessment, cancer screening and prevention, and targeted therapy, fulfilling the promise of personalized medicine. In this monograph, we review the evolution of scientific discovery in cancer genetics and genomics, and describe current approaches, benefits, and barriers to the translation of this information to the practice of preventive medicine. Summaries of known hereditary cancer syndromes and highly penetrant genes are provided and contrasted with recently discovered genomic variants associated with modest increases in cancer risk. We describe the scope of knowledge, tools, and expertise required for the translation of complex genetic and genomic test information into clinical practice. The challenges of genomic counseling include the need for genetics and genomics professional education and multidisciplinary team training, the need for evidence-based information regarding the clinical utility of testing for genomic variants, the potential dangers posed by premature marketing of first-generation genomic profiles, and the need for new clinical models to improve access to and responsible communication of complex disease risk information. We conclude that given the experiences and lessons learned in the genetics era, the multidisciplinary model of genetic cancer risk assessment and management will serve as a solid foundation to support the integration of personalized genomic information into the practice of cancer medicine.
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Affiliation(s)
- Jeffrey N Weitzel
- Division of Clinical Cancer Genetics, Department of Population Sciences, City of Hope, Duarte, CA.
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