Women whose loved ones died of cancer are far more likely to consider aggressive approaches to preventing breast cancer than those whose loved ones survived the disease, an Ohio State University study reports.
The research, “Experiencing the cancer of a loved one influences decision-making for breast cancer prevention,” was published in the Journal of Health Psychology.
“The cancer of someone you care about is a lens through which you interpret your own risk,” Tasleem Padamsee, the lead author of the study, said in a press release. “Our study suggests that that experience has an impact on how women make decisions about prevention.”
Padamsee’s team talked with 50 women at higher risk of breast cancer to try to understand why some opt for protective approaches such as medication and others for more aggressive measures, such as breast tissue removal.
The study design included open-ended questions to ensure that researchers’ ideas about the matter didn’t influence the findings, Padamsee said.
“We wanted to understand what information high-risk women are using to make their choices about genetic testing, prophylactic [preventive] surgery and medication,” she said. “We were able to learn a lot by listening to” each woman’s story.
The team found some clear trends in the answers. They divided the women into four categories, based on how they described their family and friends’ experiences with cancer. The first category was women with little or no experience with the disease. The last included those who had seen a loved one die of cancer in a traumatic way.
In the last group, the loved one was often the woman’s mother, and the cancer was breast cancer.
The breast cancer risk of most of the women who were interviewed was above average.
The options that women whose risk is higher than 20 percent can opt for range from frequent monitoring of the condition of their breasts, to preventive removal of breasts, to taking anti-estrogen medication like tamoxifen.
Padamsee discovered that women who had watched loved ones die of cancer were much more open to aggressive preventive methods.
“Women who had traumatic experiences were more likely to view breast cancer as a death sentence, while those with more positive experiences perceived it as a hardship, but one that could be overcome,” she said. “And the women who had a trauma are the ones who were really willing to consider more aggressive options.”
Women who had not been through a traumatic cancer experience preferred mammography as a preventive breast cancer tool and were willing to have genetic testing. But they were not open to more aggressive approaches unless a genetic test confirmed they had a life-threatening predisposition to breast cancer.
Some answers caused Padamsee concern. Some women said they were not aware of prevention options that might fit them. A number said financial limitations discouraged them from genetic testing.
In the future, the research team plans to examine factors such as socioeconomic status and race that could contribute to preventive choices.
Of the 50 women interviewed, 30 were white and 20 African-American. The African-Americans were more likely to characterize breast cancer as a condition that could be prevented only by mammography.
Padamsee hypothesized that this could reflect barriers to specialist care that prevent African-Americans from learning about other protective options.
“My goal is to empower women so that they know their risks and their options and can make the healthcare choices that are consistent with their own values,” she said.
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