A retrospective study on surveillance behavior and prophylaxis after genetic testing for hereditary breast and ovarian cancer in Hong Kong Chinese families.

Abstract

e12017 Background: Studies in the West have shown that the uptake rates of surveillance and prophylaxis may be different in BRCA mutation carriers and non carriers and this may vary between different ethnicities. To date there is no data available for the behavioural pattern of Asian cohorts. The present study is the first to investigate the behavioural impact and medical compliance in Hong Kong Chinese high risk families who had undergone BRCA1 and BRCA2 genetic testing up to 1 year after genetic testing. Methods: 61 individuals who had BRCA1 and BRCA2 genetic testing previously performed by the Hong Kong Hereditary Breast Cancer Family Registry were surveyed by a face-to-face or telephone interview. Sociodemographic information, genetic test results, pre-and post-testing surveillance, medical regimes, and attitudes towards clinical management were obtained by interviews and retrieval of medical records using a prospective database. Results: 35 carriers and 26 noncarriers of a BRCA 1/2 mutations were interviewed. 71.4% of carriers and 88.5% noncarriers had cancer prior to testing. The take-up rate of clinical breast examination and mammography by female carriers (75%) and noncarriers (82.6%) remained high after knowing the test results. 31.6% and 17.4% of the eligible carriers had prophylactic mastectomy and oophorectomy respectively. 66.7% of carriers (40% of noncarriers) underwent ovarian surveillance. Interestingly, 14.8% of carriers (15.4% of noncarriers) added Chinese medicine as complementary treatment after knowing the genetic test result. Clinicians' advice was perceived as the major reason of choosing a particular surveillance strategy. Conclusions: As population-based breast and ovarian screening is unavailable in Hong Kong, the relatively high take-up rate of screening among noncarriers may be the enhancement of health-consciousness as a result of cancer experience. Proper education by clinicians is crucial for high-risk Chinese patients due to the cultural characteristic of medical compliance. A prospective study will contribute to the understanding of attitude-change towards clinical management of this population. No significant financial relationships to disclose.