Patient-Reported Outcome Measures may optimize shared decision-making for cancer risk management in BRCA mutation...

Area of Science:

• Oncology
• Genetics
• Patient-Reported Outcomes

Background:

• BRCA1/2 mutations significantly increase breast cancer risk.
• Risk management strategies include surveillance or bilateral prophylactic mastectomy (BPM).
• Patient-reported outcomes (PROs) are crucial for informed decision-making.

Purpose of the Study:

• Compare PROs between BRCA1/2 carriers undergoing BPM with immediate breast reconstruction (BPM-IBR) versus surveillance.
• Inform shared decision-making for cancer risk management in this population.

Main Methods:

• 96 unaffected BRCA1/2 carriers were analyzed: one group post-BPM-IBR, the other under surveillance.
• Participants completed the Hospital Anxiety and Depression Scale (HADS) and BREAST-Q.
• PROs were compared between groups and with normative data.

Main Results:

• No participants reported anxiety or depression (HADS scores < 8).
• The surveillance group reported significantly higher 'Q-physical well-being' scores than the BPM-IBR group (p=0.011).
• Both groups reported better outcomes than age-matched normative data.

Conclusions:

• BPM-IBR and surveillance are associated with good mental health in BRCA1/2 carriers.
• Surveillance offers superior physical well-being compared to BPM-IBR.
• Longitudinal PRO data and reference values are needed to enhance shared decision-making for breast cancer risk management.