Woodson Ashley H, Muse Kimberly I, Lin Heather, Jackson Michelle, Mattair Danielle N, Schover Leslie, Woodard Terri, McKenzie Laurie, Theriault Richard L, Hortobágyi Gabriel N, Arun Banu, Peterson Susan K, Profato Jessica, Litton Jennifer K
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Oncologist. 2014 Aug;19(8):797-804. doi: 10.1634/theoncologist.2014-0057. Epub 2014 Jun 20.
Women with premenopausal breast cancer may face treatment-related infertility and have a higher likelihood of a BRCA mutation, which may affect their attitudes toward future childbearing.
Premenopausal women were invited to participate in a questionnaire study administered before and after BRCA genetic testing. We used the Impact of Event Scale (IES) to evaluate the pre- and post-testing impact of cancer or carrying a BRCA mutation on attitudes toward future childbearing. The likelihood of pursuing prenatal diagnosis (PND) or preimplantation genetic diagnosis (PGD) was also assessed in this setting. Univariate analyses determined factors contributing to attitudes toward future childbearing and likelihood of PND or PGD.
One hundred forty-eight pretesting and 114 post-testing questionnaires were completed. Women with a personal history of breast cancer had less change in IES than those with no history of breast cancer (p = .003). The 18 BRCA-positive women had a greater change in IES than the BRCA-negative women (p = .005). After testing, 31% and 24% of women would use PND and PGD, respectively. BRCA results did not significantly affect attitudes toward PND/PGD.
BRCA results and history of breast cancer affect the psychological impact on future childbearing. Intentions to undergo PND or PGD do not appear to change after disclosure of BRCA results. Additional counseling for patients who have undergone BRCA testing may be warranted to educate patients about available fertility preservation options.
绝经前乳腺癌女性可能面临与治疗相关的不孕问题，且携带BRCA突变的可能性更高，这可能会影响她们对未来生育的态度。
邀请绝经前女性参与一项在BRCA基因检测前后进行的问卷调查研究。我们使用事件影响量表（IES）来评估癌症或携带BRCA突变在检测前后对未来生育态度的影响。在此背景下，还评估了进行产前诊断（PND）或植入前基因诊断（PGD）的可能性。单因素分析确定了影响未来生育态度以及PND或PGD可能性的因素。
完成了148份检测前问卷和114份检测后问卷。有乳腺癌个人史的女性在IES上的变化小于无乳腺癌病史的女性（p = 0.003）。18名BRCA阳性女性在IES上的变化大于BRCA阴性女性（p = 0.005）。检测后，分别有31%和24%的女性会使用PND和PGD。BRCA检测结果对PND/PGD态度没有显著影响。
BRCA检测结果和乳腺癌病史会影响对未来生育的心理影响。BRCA检测结果披露后，进行PND或PGD的意愿似乎没有改变。对于接受BRCA检测的患者，可能需要额外的咨询，以教育患者了解可用的生育力保存选择。
