passages: 3685
passages: document
passages: Effects of individualized breast cancer risk counseling : a randomized trial . BACKGROUND Studies have shown that a majority of women with a family history of breast cancer have exaggerated perceptions of their own risk of this disease and experience excessive anxiety . In response to the need to communicate more accurate risk information to these women , specialized programs for breast cancer risk counseling have been initiated in medical centers across the United States . PURPOSE Our purpose was 1 ) to evaluate the impact of a standardized protocol for individualized breast cancer risk counseling on comprehension of personal risk among first-degree relatives of index breast cancer patients and 2 ) to identify women most and least likely to benefit from such counseling . METHODS This study is a prospective randomized trial comparing individualized breast cancer risk counseling to general health counseling ( control ) . We studied 200 women aged 35 years and older who had a family history of breast cancer in a first-degree relative . Women with a personal history of cancer were excluded . Risk comprehension was assessed as the concordance between perceived " subjective " lifetime breast cancer risk and estimated " objective " lifetime risk . RESULTS The results of logistic regression analysis showed that women who received risk counseling were significantly more likely to improve their risk comprehension , compared with women in the control condition ( odds ratio [ OR ] = 3.5 ; 95 % confidence interval [ CI ] = 1.3-9.5 ; P = .01 ) . However , in both groups , about two thirds of women continued to overestimate their lifetime risks substantially following counseling . Examination of subjects by treatment interaction effects indicated that risk counseling did not produce improved comprehension among the large proportion of women who had high levels of anxious preoccupation with breast cancer at base line ( P = .02 ) . In addition , white women were less likely to benefit than African-American women ( OR = 0.34 ; 95 % CI = 0.11-0.99 ; P = .05 ) . CONCLUSION Efforts to counsel women about their breast cancer risks are not likely to be effective unless their breast cancer anxieties are also addressed . IMPLICATIONS Attention to the psychological aspects of breast cancer risk will be critical in the development of risk-counseling programs that incorporate testing for the recently cloned breast cancer susceptibility gene , BRCA1 ( and BRCA2 when that gene has also been cloned ) .
entities: 3686
entities: Intervention_Psychological
entities: individualized breast cancer risk counseling :
entities: 3687
entities: Intervention_Psychological
entities: individualized breast cancer risk counseling
entities: 3688
entities: Intervention_Psychological
entities: individualized breast cancer risk counseling
entities: 3689
entities: Intervention_Control
entities: general health counseling ( control ) .
entities: 3690
entities: Intervention_Psychological
entities: risk counseling
entities: 3691
entities: Intervention_Psychological
entities: risk counseling
entities: 3692
entities: Intervention_Psychological
entities: risk-counseling programs
entities: 3693
entities: Outcome_Mental
entities: comprehension of personal risk
entities: 3694
entities: Outcome_Mental
entities: Risk comprehension
entities: 3695
entities: Outcome_Mental
entities: risk comprehension
entities: 3696
entities: Outcome_Mental
entities: lifetime risks
entities: 3697
entities: Outcome_Mental
entities: comprehension
entities: 3698
entities: Participant_Condition
entities: first-degree relatives of index breast cancer patients
entities: 3699
entities: Participant_Sample-size
entities: 200
entities: 3700
entities: Participant_Sex
entities: women
entities: 3701
entities: Participant_Age
entities: aged 35 years and older
entities: 3702
entities: Participant_Condition
entities: family history of breast cancer in a first-degree relative
entities: 3703
entities: Participant_Condition
entities: Women
entities: 3704
entities: Participant_Condition
entities: personal history of cancer