Vetter Lisa, Keller Monika, Bruckner Thomas, Golatta Michael, Eismann Sabine, Evers Christina, Dikow Nicola, Sohn Christof, Heil Jörg, Schott Sarah
Department of Obstetrics and Gynecology, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Department of Psychosomatic, Internal Medicine, University Hospital Heidelberg, Heidelberg, Germany.
Breast Cancer Res Treat. 2016 Apr;156(2):289-99. doi: 10.1007/s10549-016-3748-5. Epub 2016 Mar 9.
Breast cancer (BC) is the leading cancer among women worldwide and in 5-10 % of cases is of hereditary origin, mainly due to BRCA1/2 mutations. Therefore, the German Consortium for Familial Breast and Ovarian Cancer (HBOC) with its 15 specialized academic centers offers families at high risk for familial/hereditary cancer a multimodal breast cancer surveillance program (MBCS) with regular breast MRI, mammography, ultrasound, and palpation. So far, we know a lot about the psychological effects of genetic testing, but we know little about risk-correlated adherence to MBCS or prophylactic surgery over time. The aim of this study was to investigate counselees' adherence to recommendations for MBCS in order to adjust the care supply and define predictors for incompliance. All counselees, who attended HBOC consultation at the University Hospital Heidelberg between July 01, 2009 and July 01, 2011 were eligible to participate. A tripartite questionnaire containing sociodemographic information, psychological parameters, behavioral questions, and medical data collection from the German consortium were used. A high participation rate was achieved among the study population, with 72 % returning the questionnaire. This study showed a rate of 59 % of full-adherers to the MBCS. Significant predictors for partial or full adherence were having children (p = 0.0221), younger daughters (p = 0.01795), a higher awareness of the topic HBOC (p = 0.01795, p < 0.0001), a higher perceived breast cancer risk (p < 0.0001), and worries (p = 0.0008)/impairment (p = 0.0257) by it. Although the current data suggest a good adherence of MBCS, prospective studies are needed to understand counselees' needs to further improve surveillance programs and adherence to them. Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening-a monocenter study in Germany.
乳腺癌（BC）是全球女性中最常见的癌症，5%-10%的病例为遗传性，主要归因于BRCA1/2基因突变。因此，由15个专业学术中心组成的德国家族性乳腺癌和卵巢癌联盟（HBOC）为有家族性/遗传性癌症高风险的家庭提供了一项多模式乳腺癌监测计划（MBCS），包括定期进行乳腺磁共振成像（MRI）、乳房X线摄影、超声检查和触诊。到目前为止，我们对基因检测的心理影响了解很多，但对于随着时间推移与风险相关的MBCS或预防性手术的依从性了解甚少。本研究的目的是调查咨询对象对MBCS建议的依从性，以便调整护理服务并确定不依从的预测因素。所有在2009年7月1日至2011年7月1日期间到海德堡大学医院参加HBOC咨询的咨询对象均有资格参与。使用了一份包含社会人口统计学信息、心理参数、行为问题以及来自德国联盟的医疗数据收集的三方问卷。研究人群的参与率很高，72%的人返回了问卷。本研究显示，完全遵守MBCS的比例为59%。部分或完全依从的显著预测因素包括有子女（p = 0.0221）、较年轻的女儿（p = 0.01795）、对HBOC主题的更高认知度（p = 0.01795，p < 0.0001）、更高的感知乳腺癌风险（p < 0.0001）以及由此产生的担忧（p = 0.0008）/损害（p = 0.0257）。尽管目前的数据表明MBCS的依从性良好，但仍需要前瞻性研究来了解咨询对象的需求，以进一步改进监测计划及其依从性。家族性乳腺癌和卵巢癌风险女性对乳腺癌监测计划的依从性与过度筛查——德国的一项单中心研究
