Department of Psychiatry, Faculty of Medicine, University of Toronto, Princess Margaret Cancer Centre, Director, de Souza Institute, University Health Network, Toronto, Canada.
Department of Psychiatry, Faculty of Medicine, University of Toronto, Mount Sinai Hospital, Toronto, Canada.
Psychooncology. 2018 Nov;27(11):2645-2653. doi: 10.1002/pon.4822. Epub 2018 Jul 17.
Women with a family history of breast cancer (BC) often overestimate their BC risk. Heightened psychological distress may interfere with risk comprehension and screening adherence. The primary purpose of this study was to test the efficacy of a 12-week manual-based supportive-expressive (SE) group intervention for this population.
Using a randomized control trial design, this study compared two interventions: a standard risk-counseling arm (RC) compared with that plus SE group intervention. The primary study outcome was BC anxiety. Secondary outcomes included psychosocial functioning, risk comprehension, BC knowledge, and screening behaviors.
A total of 161 women with a family history of BC were randomized into SE (N = 108) or RC (N = 53). Participants in both study arms significantly improved on measures of BC anxiety, psychosocial functioning, risk comprehension, and BC knowledge, with no statistical difference between study arms. Benefits were sustained at 1 year. BC screening rates were high in both arms at baseline and follow-up.
SE group therapy as an added intervention to the risk counseling was well-received, however, did not demonstrate superiority to RC alone. Future studies on treatment matching are needed to further our understanding of interventions that can support women with a family history of BC to work through residual issues, including loss and grief.
有乳腺癌家族史的女性常常会过高估计自身的乳腺癌风险。高度的心理困扰可能会干扰风险认知和筛查的依从性。本研究的主要目的是测试 12 周基于手册的支持-表达（SE）小组干预措施对此类人群的疗效。
本研究采用随机对照试验设计，比较了两种干预措施：标准风险咨询组（RC）与 SE 组联合干预。主要研究结果是乳腺癌焦虑。次要结果包括心理社会功能、风险认知、乳腺癌知识和筛查行为。
共有 161 名有乳腺癌家族史的女性被随机分配到 SE 组（N=108）或 RC 组（N=53）。两组研究参与者在乳腺癌焦虑、心理社会功能、风险认知和乳腺癌知识方面均有显著改善，组间无统计学差异。在 1 年时仍有获益。两组的乳腺癌筛查率在基线和随访时均较高。
SE 小组治疗作为风险咨询的附加干预措施受到欢迎，但与单独 RC 相比并未显示出优越性。需要进一步开展关于治疗匹配的研究，以深入了解能够支持有乳腺癌家族史的女性解决遗留问题（包括丧失和悲伤）的干预措施。
