Breast Cancer Risk and Psychosocial Adjustment Among Adolescents

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Breast cancer–specific distress, though offset by psychosocial adjustment, is higher among adolescents at high risk of developing breast cancer.
Breast cancer–specific distress, though offset by psychosocial adjustment, is higher among adolescents at high risk of developing breast cancer.

Breast cancer–specific distress, though offset by psychosocial adjustment, is higher among adolescents at high risk of developing breast cancer, according to a study published in the Journal of Clinical Oncology.1

“There has been increasing interest in testing children for BRCA1/2 mutations. Additionally, there are some data to suggest that adolescent behaviors could affect future breast cancer risk,” said Angela R. Bradbury, MD, of the departments of medicine, hematology/oncology and medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and lead author of the study, in an interview with Cancer Therapy Advisor.

Previous studies found that girls age 10 to 13 with a family history of breast cancer, and young women age 18 to 24 with mothers with BRCA mutations, had higher cancer–specific stress compared with their peers, though their psychosocial adjustment was not affected.2,3

“To consider talking with girls about genetic or behavioral risks, we thought it important to first understand if girls in breast cancer families and those with BRCA1/2 mutations differ from their peers in adjustment, distress, or behaviors,” Dr Bradbury told Cancer Therapy Advisor.

Researchers recruited 320 young women from 247 families from pediatric practices in the Philadelphia area, the clinical cancer genetics program at the University of Pennsylvania and Fox Chase Cancer Center, the Facing Our Risk of Cancer Empowered nonprofit awareness group, community advertisements, and friend-nomination by mothers.

Overall, 65% of the young women had a family history of breast cancer, referred to as “breast cancer family history (BCFH) positive.” Thirty-three percent of the cohort had BRCA–positive mothers. Of those whose mothers were BRCA-positive, 55% were aware of their mother's status. Characteristics were similar between BCFH-positive and -negative participants, except that those with BRCA-positive mothers were younger.

The BCFH-positive group demonstrated higher total breast cancer-specific stress, with a mean score of 4.9 (on a 0 to 38 scale); those in the BCFH-negative group scored 1.8. There was, however, no significant difference in general anxiety, depression, or the composite internalizing score between the groups.

Participants in the BCFH-positive group scored higher in self-esteem than those in the BCFH-negative group (57.7 versus 48.3%, respectively). According to Dr Bradbury, this discrepancy “may be a result of developing early coping skills as a result of facing cancer in the family.”

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