Physicians communicating with women at genetic risk of breast and ovarian cancer: Are we in the middle of the ford between contradictory messages and unshared decision making?

Details

Serval ID
serval:BIB_491D68830C89
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Physicians communicating with women at genetic risk of breast and ovarian cancer: Are we in the middle of the ford between contradictory messages and unshared decision making?
Journal
PloS one
Author(s)
Fadda M., Chappuis P.O., Katapodi M.C., Pagani O., Monnerat C., Membrez V., Unger S., Caiata Zufferey M.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2020
Peer-reviewed
Oui
Volume
15
Number
10
Pages
e0240054
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
BRCA1/2 genetic testing offers tremendous opportunities for prevention, diagnosis and treatment of breast and ovarian cancer. Women acquire valuable information that can help them to make informed decisions about their health. However, knowing one's susceptibility to developing cancer may be burdensome for several women, as this risk needs to be managed over time through a continuous dialogue with multiple healthcare professionals. We explored how communication between physicians and unaffected women carrying BRCA1/2 germline pathogenic variants was experienced by women in relation to their genetic risk. Data came from qualitative interviews conducted in Switzerland with 32 unaffected women carrying BRCA1/2 pathogenic variants and aware of their genetic status for at least 3 years. We identified three different types of message as conveyed by physicians to women: (1) a normative message, (2) an over-empowering message, and (3) a minimizing message. On one hand, we found that women are exposed to contradictory messages, often simultaneously, in their interactions with healthcare professionals during their post-genetic testing journey. On the other hand, women's reports highlighted the absence of shared decision-making in such interactions. The combination of these two findings resulted in a strong sense of disorientation, frustration, and powerlessness among participants. Healthcare professionals interacting with high cancer risk women are urged to align in favor of a both concerted and shared decision-making approach when discussing options for managing genetic risk.
Keywords
Adult, BRCA1 Protein/genetics, BRCA2 Protein/genetics, Breast Neoplasms/genetics, Breast Neoplasms/pathology, Decision Making, Female, Genetic Counseling, Grounded Theory, Humans, Middle Aged, Ovarian Neoplasms/genetics, Ovarian Neoplasms/pathology, Physician-Patient Relations, Physicians/psychology, Risk Factors
Pubmed
Web of science
Open Access
Yes
Create date
26/10/2020 8:37
Last modification date
13/02/2024 8:25
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