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. 2019 Nov;28(11):2226-2232.
doi: 10.1002/pon.5211. Epub 2019 Sep 2.

Risk estimation, anxiety, and breast cancer worry in women at risk for breast cancer: A single-arm trial of personalized risk communication

Zhuoer Xie  1 , Neil Wenger  2 , Annette L Stanton  3 , Karen Sepucha  4 , Celia Kaplan  5 , Lisa Madlensky  6 , David Elashoff  7 , Jacqueline Trent  1 , Antonia Petruse  1 , Liliana Johansen  1 , Tracy Layton  8 , Arash Naeim  9
Affiliations

Risk estimation, anxiety, and breast cancer worry in women at risk for breast cancer: A single-arm trial of personalized risk communication

Zhuoer Xie et al. Psychooncology. 2019 Nov.

Abstract

Objective: Elevated anxiety and breast cancer worry can impede mammographic screening and early breast cancer detection. Genetic advances and risk models make personalized breast cancer risk assessment and communication feasible, but it is unknown whether such communication of risk affects anxiety and disease-specific worry. We studied the effect of a personalized breast cancer screening intervention on risk perception, anxiety, and breast cancer worry.

Methods: Women with a normal mammogram but elevated risk for breast cancer (N = 122) enrolled in the Athena Breast Health risk communication program were surveyed before and after receiving a letter conveying their breast cancer risk and a breast health genetic counselor consultation. We compared breast cancer risk estimation, anxiety, and breast cancer worry before and after risk communication and evaluated the relationship of anxiety and breast cancer worry to risk estimation accuracy.

Results: Women substantially overestimated their lifetime breast cancer risk, and risk communication somewhat mitigated this overestimation (49% pre-intervention, 42% post-intervention, 13% Gail model risk estimate, P < .001). Both general anxiety and breast cancer worry declined significantly after risk communication in women with high baseline anxiety. Baseline anxiety and breast cancer worry were essentially unrelated to risk estimation accuracy, but risk communication increased alignment of worry with accuracy of risk assessment.

Conclusions: Personalized communication about breast cancer risk was associated with modestly improved risk estimation accuracy in women with relatively low anxiety and less anxiety and breast cancer worry in women with higher anxiety. We detected no negative consequences of informing women about elevated breast cancer risk.

Keywords: anxiety; breast cancer worry; oncology; perceived risk; risk communication.

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Conflict of interest statement

Conflict of interest

The authors declare no potential conflicts of interest related to the data reported in this manuscript.

Figures

Figure 1
Figure 1
Plot of Women’s Numerical Risk Estimate v Gail Model Lifetime Breast Cancer Risk, Before and After Risk Communication Values on the line of equality represent accurate breast cancer risk estimations. Points above the line are overestimates and points below the line are underestimates.
Figure 2
Figure 2
Correlations between Anxiety and Breast Cancer Worry with Accuracy of Breast Cancer Risk Estimation before and after risk communication Risk-estimation accuracy is Personal lifetime risk estimate minus Gail model breast cancer lifetime risk estimate.
See this image and copyright information in PMC

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