BRACAVENIR: an observational study of expectations and coping in young women with high hereditary risk of breast and ovarian cancer

Fabrice KwiatkowskiEmail author View ORCID ID profile,
Mathilde Gay-Bellile,
Pascal Dessenne,
Claire Laquet,
Véronique Boussion,
Marie Béguinot,
Marie-Françoise Petit,
Anne-Sophie Grémeau,
Céline Verlet,
Charlotte Chaptal,
Marilyn Broult,
Sylvie Jouvency,
Martine Duclos and
Yves-Jean Bignon

Hereditary Cancer in Clinical Practice201917:7

https://doi.org/10.1186/s13053-019-0107-7

Received: 31 July 2018
Accepted: 20 February 2019
Published: 27 February 2019

Open Peer Review reports

Abstract

Background

In families with high risk of hereditary breast/ovarian cancer (HBOC), women before age 30 do not yet undergo clinical screening, but they are exposed to contradictory information from diverse sources. They may be presented with surgical prevention options at a key moment of their identity construction, the start of a marital relationship and/or at the onset of procreation projects. We tested an original psychoeducational intervention to help these women better cope with these difficult issues.

Methods

Seven young female counselees (26.4 ± 2.9 years [23–30]) from the Oncogenetics Department at Jean Perrin Comprehensive Cancer Center were enrolled. A weekend group workshop composed of short conferences, group sharing and role playing activities was supervised by a psychotherapist. A longitudinal analysis of questionnaires over one year of follow-up was performed. The Herth Hope Inventory was evaluated, as well as self-esteem, anxiety, perceived control, coping, and quality of life. Participants’ comments were collected by a genetic counselor throughout the workshop.

Results

All participants were BRCA mutation carriers and six had lived with a close relative affected by breast/ovarian cancer. Hope, self-esteem and quality of life increased during the year after the workshop (p = 0.0003). Coping by focus on the problem increased in the first 6 months (p = 0.011) and returned to baseline values at one year, while coping by focus on emotions decreased steadily (p = 0.021). Debriefing from the workshop highlighted the new medical opportunities proposed and the challenges these young women face, such as whether to have prophylactic surgery, and if so before or after having children, and how surgery might affect their relationship with their partner.

Conclusion

A tailored two-day psychoeducational workshop may be sufficient to improve the way young women with BRCA mutations deal with the implications of HBOC risk.