Lerman C, Schwartz M
Population Science Division, Fox Chase Cancer Center, Philadelphia, PA.
Breast Cancer Res Treat. 1993 Nov;28(2):145-55. doi: 10.1007/BF00666427.
Increasingly, women with a positive family history of breast cancer are being targeted for cancer prevention and control efforts. Two findings have been demonstrated consistently across studies of this high risk population. First, these women often have high levels of psychological distress, as well as persistent and intrusive worries about developing breast cancer. Second, despite their increased risk for developing breast cancer, a substantial proportion of these women do not adhere to recommended breast cancer screening guidelines. There is growing evidence that psychological distress is an important barrier to adherence among high risk women. Despite this, little is known about how to intervene to improve psychological adjustment and adherence in this population. In the present paper, we review the literature on adherence and psychological adjustment in women who are at increased risk for breast cancer because of a positive family history of disease. This review provides the basis for a discussion of potential intervention strategies designed to increase adherence and reduce psychological distress in this population. Finally, we present some of the psychological implications of recent developments in genetic testing for breast cancer susceptibility.
乳腺癌家族史呈阳性的女性越来越多地成为癌症预防和控制工作的目标人群。在针对这一高危人群的各项研究中，有两项发现始终得到证实。其一，这些女性往往存在高度的心理困扰，以及对患乳腺癌持续且侵扰性的担忧。其二，尽管她们患乳腺癌的风险增加，但相当一部分此类女性并未遵循推荐的乳腺癌筛查指南。越来越多的证据表明，心理困扰是高危女性坚持筛查的重要障碍。尽管如此，对于如何进行干预以改善这一人群的心理调适和坚持筛查情况，我们知之甚少。在本文中，我们回顾了关于因疾病家族史呈阳性而患乳腺癌风险增加的女性坚持筛查和心理调适的相关文献。这一综述为讨论旨在提高该人群坚持筛查率并减轻心理困扰的潜在干预策略提供了基础。最后，我们阐述了乳腺癌易感性基因检测最新进展所带来的一些心理影响。
