Wagner T M, Möslinger R, Langbauer G, Ahner R, Fleischmann E, Auterith A, Friedmann A, Helbich T, Zielinski C, Pittermann E, Seifert M, Oefner P
Department of Obstetrics and Gynaecology, General Hospital, University of Vienna, Austria.
Br J Cancer. 2000 Apr;82(7):1249-53. doi: 10.1054/bjoc.1999.1086.
The intent of this study was to evaluate the effect that an awareness of being a BRCA1 or BRCA2 mutation carrier has on the attitude towards prophylactic surgery and on developing depression symptoms. Thirty-five families were selected on the basis of previously detected BRCA1 or 2 mutations and 90 family members were given the appropriate questionnaires. Prophylactic mastectomy (PM) was considered by 21% of the Austrian mutation carriers (29% affected and 8% non-affected carriers). The majority of affected and non-affected carriers expected PM to impair the quality of their life. Fifty per cent would undergo prophylactic oophorectomy (53% affected and 46% non-affected carriers). The self-rating depression scale indicated that following mutation result disclosure the depression scores of carriers decreased (40 baseline vs 38 after result disclosure, P = 0.3), whereas, for non-carriers, scores increased (36 baseline vs 40 after result disclosure, P = 0.05). We conclude that information about carrier status is not associated with increased depression symptoms in mutation carriers. In non-carriers, depression scores increased slightly, probably reflecting survivor guilt. The option of having PM was associated with a negative impact on the quality of life and was declined by the majority of Austrian mutation carriers.
本研究旨在评估知晓自己为BRCA1或BRCA2突变携带者这一情况对预防性手术态度及抑郁症状发展的影响。基于先前检测出的BRCA1或2突变，选取了35个家庭，并向90名家庭成员发放了合适的问卷。21%的奥地利突变携带者考虑进行预防性乳房切除术（PM）（29%的患病携带者和8%的未患病携带者）。大多数患病和未患病携带者预计PM会损害其生活质量。50%的人会接受预防性卵巢切除术（53%的患病携带者和46%的未患病携带者）。自评抑郁量表显示，在突变结果披露后，携带者的抑郁得分下降（基线时为40分，结果披露后为38分，P = 0.3），而对于非携带者，得分上升（基线时为36分，结果披露后为40分，P = 0.05）。我们得出结论，关于携带者状态的信息与突变携带者抑郁症状增加无关。在非携带者中，抑郁得分略有上升，可能反映了幸存者内疚感。选择进行PM对生活质量有负面影响，大多数奥地利突变携带者拒绝了这一选择。
