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 [F] Diseases Research  / PubMed Research Articles  /
Preferences for breast cancer risk reduction among BRCA1/BRCA2 mutation carriers: a discrete-choice experiment.




Breast cancer research and treatment 2017 Jun 18; ()


Liede A1; Mansfield CA2; Metcalfe KA3; Price MA4; Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer5; Snyder C6; Lynch HT7; Friedman S8; Amelio J9; Posner J10; Narod SA11; Lindeman GJ12; Evans DG13;

Author Information
  • 1Amgen Inc, South San Francisco, CA, USA.
  • 2RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC, 27709, USA. carolm@rti.org.
  • 3Women's College Hospital, University of Toronto, Toronto, Canada.
  • 4Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, Australia.
  • 6Creighton University, Omaha, NE, USA.
  • 7Creighton University, Omaha, NE, USA.
  • 8Facing Our Risk of Cancer Empowered (FORCE) Advocacy Organization, Tampa, FL, USA.
  • 9Amgen Ltd, Uxbridge, UK.
  • 10RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC, 27709, USA.
  • 11Women's College Hospital, University of Toronto, Toronto, Canada.
  • 12The Royal Melbourne Hospital, Parkville, Australia.
  • 13Manchester Centre for Genomic Medicine, University of Manchester, Manchester, UK.


PURPOSE: Unaffected women who carry BRCA1 or BRCA2 mutations face difficult choices about reducing their breast cancer risk. Understanding their treatment preferences could help us improve patient counseling and inform drug trials. The objective was to explore preferences for various risk-reducing options among women with germline BRCA1/2 mutations using a discrete-choice experiment survey and to compare expressed preferences with actual behaviors.

METHODS: A discrete-choice experiment survey was designed wherein women choose between hypothetical treatments to reduce breast cancer risk. The hypothetical treatments were characterized by the extent of breast cancer risk reduction, treatment duration, impact on fertility, hormone levels, risk of uterine cancer, and ease and mode of administration. Data were analyzed using a random-parameters logit model. Women were also asked to express their preference between surgical and chemoprevention options and to report on their actual risk-reduction actions. Women aged 25-55 years with germline BRCA1/2 mutations who were unaffected with breast or ovarian cancer were recruited through research registries at five clinics and a patient advocacy group.

RESULTS: Between January 2015 and March 2016, 622 women completed the survey. Breast cancer risk reduction was the most important consideration expressed, followed by maintaining fertility. Among the subset of women who wished to have children in future, the ability to maintain fertility was the most important factor, followed by the extent of risk reduction. Many more women said they would take a chemoprevention drug than had actually taken chemoprevention.

CONCLUSIONS: Women with BRCA1/2 mutations indicated strong preferences for breast cancer risk reduction and maintaining fertility. The expressed desire to have a safe chemoprevention drug available to them was not met by current chemoprevention options.




Publication Type: Journal Article

This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.

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