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Annals of Oncology 15:726-732, 2004
© 2004 European Society for Medical Oncology

Original Paper

An oncologist-based model of cancer genetic counselling for hereditary breast and ovarian cancer

Received 22 September 2003; revised 28 November 2003; accepted 21 January 2004

Background:

We describe a multistep model of cancer genetic counselling designed to promote awareness, and disease surveillance and preventive measures for hereditary and familial breast and ovarian cancer.

Patients and methods:

Step T0 of the model entails information giving; this is followed by pedigree analysis and risk estimation (T1), risk communication and genetic testing (T2), and genetic test result communication (T3). User consent was required to proceed from one step to the next. Surveillance and preventive measures are proposed to at-risk users. Of the 311 subjects who requested cancer genetic counselling, consent data to each counselling step were available for 295: 93 were disease-free, 187 had breast cancer, 12 had ovarian cancer and three had breast plus ovarian cancer.

Results:

Consent was high at T0 (98.39%), T1 (96.40%) and T2 (99.65%). Consent decreased at the crucial points of counselling: T2 (87.71%) and T3 [genetic test result communication (85.08%), and extension of counselling to and testing of relatives (65.36%)].

Conclusions:

The model fosters the user’s knowledge about cancer and favours identification of at-risk subjects. Furthermore, by promoting awareness about genetic testing and surveillance measures, the algorithm enables users to make a fully informed choice of action in case of predisposing or familial cancer risk.

A. Contegiacomo1,*, M. Pensabene1, I. Capuano1, L. Tauchmanova1, M. Federico2, D. Turchetti2, L. Cortesi2, P. Marchetti3, E. Ricevuto4, G. Cianci4, S. Venuta3, V. Barbieri3 and V. Silingardi2

1 Department of Molecular and Clinical Endocrinology and Oncology, University of Naples ‘Federico II’, Naples; 2 Department of Medical Oncological Research, University of Modena and Reggio Emilia; 3 Department of Clinical and Experimental Medicine ‘G. Salvatore’, University of Catanzaro ‘Magna Graecia’; 4 Department of Experimental Medicine, University of L’Aquila, Italy

Key words: breast cancer, genetic counselling, ovarian cancer


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