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Prevention and genetic testing for breast cancer: variations in medical decisions

Author

Listed:
  • Bouchard, Louise
  • Blancquaert, I.
  • Eisinger, F.
  • Foulkes, W. D.
  • Evans, G.
  • Sobol, H.
  • Julian-Reynier, C.

Abstract

The discovery linking the genes BRCA1&2 to familial breast cancer played an important role in the clinical practice of geneticists and physicians. The availability of genetic tests for BRCA gene mutations prompted cancer geneticists to give information about genetic risk and to assess many women with a personal or family history of breast or ovarian cancer to inform them of preventive measures. These consist mainly of breast self-examination, mammography screening, chemoprevention and prophylactic surgery (mastectomy, oophorectomy). This paper examines clinical practices related to hereditary breast cancer testing and introduces a number of results from a survey carried out, between 1996 and 1998, in three clinics located in Montreal (Quebec, Canada), Marseilles (France) and Manchester (Great Britain). Results show substantial differences in the way cancer geneticists deal with environmental risk factors, breast and ovarian cancer testing, and chemoprevention and prophylactic surgery. Differences across cities persist in the multivariate analysis, suggesting that attitudes towards preventive measures may be partially explained by cultural factors. Different dimensions of culture are discussed including the social representation of health and risk, the interpretation of scientific evidence and the role of innovation leadership.

Suggested Citation

  • Bouchard, Louise & Blancquaert, I. & Eisinger, F. & Foulkes, W. D. & Evans, G. & Sobol, H. & Julian-Reynier, C., 2004. "Prevention and genetic testing for breast cancer: variations in medical decisions," Social Science & Medicine, Elsevier, vol. 58(6), pages 1085-1096, March.
    • Handle: RePEc:eee:socmed:v:58:y:2004:i:6:p:1085-1096
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    Cited by:

    1. Press, Nancy & Reynolds, Susan & Pinsky, Linda & Murthy, Vinaya & Leo, Michael & Burke, Wylie, 2005. "'That's like chopping off a finger because you're afraid it might get broken': Disease and illness in women's views of prophylactic mastectomy," Social Science & Medicine, Elsevier, vol. 61(5), pages 1106-1117, September.
    2. Aarden, Erik & Van Hoyweghen, Ine & Horstman, Klasien, 2011. "Constructing access in predictive medicine. Comparing classification for hereditary breast cancer risks in England, Germany and the Netherlands," Social Science & Medicine, Elsevier, vol. 72(4), pages 553-559, February.

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