Family history of breast cancer. Impact on the disease experience

Family history is the most prominent risk factor, besides advanced age, for the incidence of breast cancer among women. This study investigates differences in the experiences of women in the detection, diagnosis, and treatment of early-stage disease. The purpose of this research is to obtain a more comprehensive understanding of the impact of family history on the overall illness experience.

Self-report retrospective data obtained from in-depth interviews with a convenience sample of 179 women who had recently received a diagnosis of nonrecurrent stage 0 to IIIA breast cancer are used to compare the experiences of women with and without a family history of breast cancer (FHOBC). The authors examine differences in screening behavior, method of detection, diagnostic processes, treatment decision making, and therapy receipt, and they report the results of bivariate analyses.

The results suggest that women with FHOBC have a different disease experience than those without an affected relative. Women with FHOBC were more likely than their counterparts to comply with screening guidelines, to seek more timely care, to consult with specialists, to be influenced by the experiences of others, to feel comfortable with treatment decisions, and to receive adjuvant therapy.

Healthcare providers should be aware that compliance with mammography and therapy guidelines may vary with FHOBC. Because the better health-related behavior reported by women with affected relatives suggests that they may have higher perceived risk, physicians should be sensitive to potentially elevated levels of anxiety, provide accurate information about relative risk, put patient concerns in the proper perspective, and include family members in treatment discussions. Alternatively, women without an FHOBC appear to have less favorable screening, detection, diagnosis, and treatment decision-making behavior. Because family doctors play an important role in the care of these patients, they may need to provide special education and counseling regarding the importance of adherence to screening guidelines, recognition of relevant symptoms, initiation of timely examinations, consultation with cancer specialists, and compliance with treatment recommendations.