Risk Assessment of First-Degree Relatives of Women With Breast Cancer: A Feasibility Study

Gail J. Hurt

Richard P. McQuellon

Robert Michielutte

Daragh M. Conrad

Seth Carter

Heidi Anderson

risk assessment, breast cancer, familial risk

Purpose/Objectives: To measure psychological distress and test the feasibility of a psychological intervention to reduce distress in patients undergoing risk assessment.

Design: Descriptive.

Setting: A comprehensive cancer center located in the southeastern United States.

Sample: 20 first-degree relatives of women diagnosed with breast cancer (mean age = 42; range = 21-70) completed the risk assessment process. Three were lost to follow-up at three months, leaving a total of 17 evaluable patients.

Methods: Data collection was by means of family/medical history forms and questionnaires administered at baseline and one and three months. Participants were randomized to either a control group consisting of standard education about risk for breast cancer or to an intervention group consisting of standard education plus a psychological intervention designed to teach stress-management skills.

Main Research Variables: Psychological distress, depressive symptoms, intrusive thoughts about breast cancer, and perceived risk for developing breast cancer. FINDINGS: Delivery of a psychological intervention proved feasible. Although no statistically significant differences existed between the intervention and control groups on distress and depressive symptoms, the intervention group reported fewer intrusive thoughts about breast cancer at follow-up. Risk did not predict anxiety levels. A large majority (73%) of the women overestimated the risk of breast cancer at baseline.

Conclusions: This study demonstrated the feasibility of a multidisciplinary team approach to breast cancer risk assessment and counseling and management of psychological distress in first-degree relatives of women with breast cancer. The data suggest that a psychological intervention may reduce cancer-specific psychological distress in women at increased risk for breast cancer.

Implications for Nursing Practice: Oncology nurses can play an important role in the delivery of interventions to educate and reduce distress in women undergoing breast cancer risk assessment.

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