Higher maternal anxiety was associated with higher anxiety in daughters and poorer family communication. Higher maternal breast cancer-specific distress was associated with breast cancer-specific distress by the daughter. “A great predictor of daughter distress is mother distress. Practitioners can encourage their patients with breast cancer, women from breast cancer families, or BRCA1/2 carriers to address their own psychological responses, which will benefit their daughters,” Dr Bradbury said.

Participants in the BCFH-positive group were more likely to perceive their risk of developing breast cancer as higher than those in the BCFH-negative group.

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Andrea Farkas Patenaude, PhD, of the Dana-Farber Cancer Institute, in Boston, Massachusetts, who was not affiliated with the study, told Cancer Therapy Advisor that ovarian cancer in BRCA-positive families is also important to consider, which was not discussed in this study. “BRCA positivity conveys predisposition not just to breast cancer, but also ovarian cancer. There is somewhere between a 20% to 40% risk of developing ovarian cancer if you have a BRCA1 mutation, whereas the risk in the general population is just over 1%.”

According to Dr Patenaude, it is important that practitioners ask young women at high risk of developing breast cancer what they are feeling and thinking about: “When there’s cancer in your family, you start to worry pretty quickly, ‘am I going to get it too?’ because that is your world.”

Dr Patenaude suggested that practitioners should “refer daughters of mutation carriers for genetic counseling and then, if appropriate, for testing. If the daughter seems distressed by what she learns, then referral to a mental health specialist is recommended.”


  1. Bradbury AR, Patrick-Miller L, Schwartz LA, et al. Pyschosocial adjustment and perceived risk among adolescent girls from families with BRCA1/2 or breast cancer history. J Clin Oncol. 2016 Aug 22. doi: 10.1200/JCO.2015.66.3450 [Epub ahead of print]
  2. Bradbury AR, Patrick-Miller L, Schwartz L, et al. Psychosocial adjustment in school-age girls with a family history of breast cancer. Pediatrics. 2015;136:927-937. doi: 10.1542/peds.2015-0498
  3. Patenaude AF, Tung N, Ryan PD, et al. Young adult daughters of BRCA1/2 positive mothers: what do they know about hereditary cancer and how much do they worry? Psychooncology. 2013;22:2024-2031. doi: 10.1002/pon.3257