Counseling Strategies for Breast Cancer Risk

This study will evaluate different methods of counseling for women with a family history of breast cancer. The study will take advantage of an existing breast cancer cohort to identify family members who are candidates for counseling concerning their risk for breast cancer. Subjects from these high-risk families will be offered genetic counseling and DNA-based linkage studies to test for the presence of a BRCA1 mutation accounting for cancer risk within the family. A total of 400 other subjects will be randomized to one of 3 counseling interventions or to a comparison group. These interventions are: genetic counseling, group psychosocial counseling, or primary care provider counseling. Comparisons among study arms will be made to assess the effect of different counseling strategies on: perceived breast cancer risk, breast screening behavior, anxieties and fears about breast cancer, and other health-related feelings and behaviors. A qualitative assessment of participants' reactions to the counseling process and opinions about the risks and benefits of genetic testing will also be included. Study data will provide a broad public health perspective on the counseling needs of women with a family history of breast cancer, as well as information on the needs of high-risk families. (Co-funded with NCI. Member of CGSC)