ABSTRACT
Recorded conversations between women undergoing BRCA genetic counseling with clinicians (N = 16) and follow-up consultation letters (N = 16) were analyzed to determine how and when communicating genetic risk information to women's adolescent daughters is discussed. Themes from conversations included mothers' worries about their daughters, perceptions of their daughters' coping, educational information, and clinicians' willingness or reluctance to communicate directly with daughters about their genetic risk. Letters referred to daughters when informing mothers about autosomal dominant inheritance patterns, psychosocial considerations, and screening recommendations. Results inform the value of educating mothers about how they might discuss these issues with their adolescent daughters.
Subject(s)
Breast Neoplasms/genetics , Communication , Genetic Counseling , Genetic Predisposition to Disease , Nuclear Family/psychology , Professional-Patient Relations , Adolescent , Adult , Breast Neoplasms/psychology , Female , Follow-Up Studies , Genetic Testing , Humans , Middle Aged , Professional-Family Relations , Qualitative Research , Time Factors , Video Recording , Young AdultABSTRACT
The known susceptibility genes for breast cancer, including BRCA1 and BRCA2, only account for a minority of the familial aggregation of the disease. A recent study of 77 multiple case breast cancer families from Scandinavia found evidence of linkage between the disease and polymorphic markers on chromosome 13q21. We have evaluated the contribution of this candidate "BRCA3" locus to breast cancer susceptibility in 128 high-risk breast cancer families of Western European ancestry with no identified BRCA1 or BRCA2 mutations. No evidence of linkage was found. The estimated proportion (alpha) of families linked to a susceptibility locus at D13S1308, the location estimated by Kainu et al. [(2000) Proc. Natl. Acad. Sci. USA 97, 9603-9608], was 0 (upper 95% confidence limit 0.13). Adjustment for possible bias due to selection of families on the basis of linkage evidence at BRCA2 did not materially alter this result (alpha = 0, upper 95% confidence limit 0.18). The proportion of linked families reported by Kainu et al. (0.65) is excluded with a high degree of confidence in our dataset [heterogeneity logarithm of odds (HLOD) at alpha = 0.65 was -11.0]. We conclude that, if a susceptibility gene does exist at this locus, it can only account for a small proportion of non-BRCA1/2 families with multiple cases of early-onset breast cancer.