P2-13-08: A Retrospective Study on Surveillance Behaviour and Prophylaxis after Genetic Testing for Hereditary Breast and Ovarian Cancer among High-Risk Chinese Females.

Abstract

Abstract Background Research in the West has 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 limited comprehensive data available for the behavioural pattern of Asian cohorts. The present on-going study is the first to investigate the behavioural impact and medical compliance of Chinese high risk females who had undergone BRCA1/2 genetic testing up to 1.5 years after genetic testing. Methods: 88 females with personal or family breast and/or ovarian cancer history who had BRCA1/2 genetic testing 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 practice, chemoprevention methods used and attitudes towards clinical management were obtained. Retrieval of medical records was performed using a prospective database. Results: 39 carriers and 49 noncarriers of a BRCA 1/2 mutations were interviewed. 82.1% of carriers and 79.6% noncarriers had breast and/or ovarian cancer prior to testing. The uptake rate of breast surveillance by eligible carriers (85.2%) and noncarriers (71.1%) remained high after knowing the test results. 12.8% and 15.4% of the eligible carriers had prophylactic contralateral mastectomy and salpingo-oophorectomy respectively, while 5.1% chose to have both procedures within 1.5 years of knowing the genetic test result. Significantly more carriers (85.7%) than noncarriers (49%) underwent ovarian surveillance (p= 0.004). 25.6% of carriers and 26.5% of noncarriers with breast cancer history chose Western chemoprevention methods, while no carriers without breast cancer history chose such methods. 34.7% of carriers (30.8% of noncarriers) used Chinese herbal medicine as complementary prevention treatment after knowing the genetic test result. Clinicians’ advice was perceived as the major reason of choosing a particular surveillance or preventative strategy. Conclusions: As population-based breast screening is unavailable in Hong Kong, the relatively high uptake rate of breast screening among noncarriers may be the result of enhancement in health-consciousness due to prior personal or family cancer experience. Proper education by clinicians is crucial to increase uptake of high risk screening. Traditional Chinese herbal medicine methods are commonly used as a form of prevention. A longitudinal prospective study will contribute to the understanding of attitude-change towards clinical management of this Chinese population who may have different cultural beliefs. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-13-08.