FAMILIAL BREAST-CANCER - A CONTROLLED-STUDY OF RISK PERCEPTION, PSYCHOLOGICAL MORBIDITY AND HEALTH BELIEFS IN WOMEN ATTENDING FOR GENETIC-COUNSELING

The present study set out to evaluate perceptions of risk, psychologic al morbidity and health behaviours in women with a family history of b reast cancer who have attended genetic counselling and determine how t hese differ from general population risk women. Data were collected fr om 62 genetic counsellees (cases) attending the Royal Marsden and Mayd ay University Hospital genetic counselling services and 62 matched GP attenders (controls). Levels of general psychological morbidity were f ound to be similar between cases and controls; however, cases reported significantly higher breast cancer-specific distress despite clinic a ttendance [mean (s.d.) total Impact of Event Scale score, 14.1 (14.3) cases; 2.4 (6.7) controls, P<0.001]. Although cases perceived themselv es to be more susceptible to breast cancer, many women failed correctl y to recall risk figures provided by the clinic; 66% could not accurat ely recall their own lifetime chance. Clinics appeared to have a posit ive impact on preventive behaviours and cases tended to engage more re gularly in breast self-examination (monthly, 66% of cases vs 47% of co ntrols), although few differences were found between groups in terms o f health beliefs. We conclude that counsellees and GP controls showed considerable similarities on many of the outcome measures, and risk of breast cancer was not predictive of greater psychological morbidity; although cases were more vulnerable to cancer-specific distress. Despi te genetic counselling, many cases continued to perceive their risk of breast cancer inaccurately.