Skip to main content
SpringerLink
Log in

Adherence and psychological adjustment among women at high risk for breast cancer

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Summary

Increasingly, women with a positive family history of breast cancer are being targeted for cancer prevention and control efforts. Two findings have been demonstrated consistently across studies of this high risk population. First, these women often have high levels of psychological distress, as well as persistent and intrusive worries about developing breast cancer. Second, despite their increased risk for developing breast cancer, a substantial proportion of these women do not adhere to recommended breast cancer screening guidelines. There is growing evidence that psychological distress is an important barrier to adherence among high risk women. Despite this, little is known about how to intervene to improve psychological adjustment and adherence in this population. In the present paper, we review the literature on adherence and psychological adjustment in women who are at increased risk for breast cancer because of a positive family history of disease. This review provides the basis for a discussion of potential intervention strategies designed to increase adherence and reduce psychological distress in this population. Finally, we present some of the psychological implications of recent developments in genetic testing for breast cancer susceptibility.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sattin RW, Rubin GL, Webster IA, et al: Family history and the risk of breast cancer. JAMA 253:1908, 1985

    Google Scholar 

  2. Stefanek ME, Wilcox P: First degree relatives of breast cancer patients: Screening practices and provision of risk information. Cancer Detect Prev 15:379–384, 1991

    Google Scholar 

  3. Vogel VG, Graves DS, Vernon SW, Lord JA, Winn RJ, Peters GN: Mammographic screening of women with increased risk of breast cancer. Cancer 66:1613–1620, 1990

    Google Scholar 

  4. Kash KM, Holland JC, Halper MS, Miller DG: Psychological distress and surveillance behaviors of women with a family history of breast cancer. JNCI 84:24–30, 1992

    Google Scholar 

  5. Lerman C, Daly M, Sands C, Balshem A, Lustbader E, Heggan T, Goldstein L, James J, Engstrom P: Mammography adherence and psychological distress among women at risk for breast cancer. JNCI 85:1074–1080, 1993

    Google Scholar 

  6. Tabar L, Dean PB: The control of breast cancer through mammography screening: What is the evidence?In: Sickles EA (ed) Radiol Clin North Am, 1987, pp 993–1005

  7. American Cancer Society: Cancer Facts and Figures. New York A.C.S., Inc., 1993

  8. Hayward RSA, Steinberg EP, Ford DE, Roisen MF, Roach KW: Preventive care guidelines. Ann Intern Med 114:758–772, 1991

    Google Scholar 

  9. Houts PS, Wojtkowiak SL, Simmonds MA, Weinberg GB, Heitjan DF: Using a state cancer registry to increase screening behaviors of sisters and daughters of breast cancer patients. Am J Publ Health 81:386–388, 1991

    Google Scholar 

  10. Kaplan KM, Weinberg GS, Small A, Herndon JL: Breast cancer screening among relatives of women with breast cancer. Am J Public Health 81:1174–1179, 1991

    Google Scholar 

  11. de Waard F, Collette HJA, Rombach JJ, Baanders-Van Halewijn EA, Honing C: The DOM project for the early detection of breast cancer, Utrecht, The Netherlands. J Chronic Dis 37:1–44, 1984

    Google Scholar 

  12. Rimer B, Keintz MK, Kessler HB, Engstrom PE, Rosan J: Why women resist mammograms: Understanding patient-related barriers to acceptance of screening mammography. Radiology 172:243–246, 1989

    Google Scholar 

  13. Lerman C, Rimer B, Trock B, Balshem A, Engstrom PF: Factors associated with repeat adherence to breast cancer screening. Prev Med 19:279–290, 1990

    Google Scholar 

  14. Polednak AP, Lane DS, Burg MA: Risk perception, family history, and use of breast cancer screening tests. Cancer Detect Prev 15, 258–263, 1991

    Google Scholar 

  15. Bondy M, Vogel VG, Halabi S, Lustbader ED: Identification of women at increased risk for breast cancer in a population-based screening program. Cancer Epidemiol Biomarkers Prev 1:143–147, 1992

    Google Scholar 

  16. Fink R, Shapiro S, Roester R: Impact of efforts to increase participation in repetitive screenings for early breast cancer detection. Am J Public Health 62:328–336, 1972

    Google Scholar 

  17. Hobbs P, Smith A, George WD, Sellwood RA: Acceptors and rejectors of an invitation to undergo breast screening compared with those who referred themselves. J Epidemiol Community Health 34:19–22, 1980

    Google Scholar 

  18. Laville EA, Vernon SW, Jackson GL, Hughes JI: Comparison of participants and nonparticipants in a work site cancer awareness and screening program. J Occup Med 31:221–232, 1989

    Google Scholar 

  19. Rutledge DN, Hartmann WH, Kinman PO, Winfield AC: Exploration of factors affecting mammography behaviors. Prev Med 17:412–422, 1988

    Google Scholar 

  20. Stefanek ME, Wilcox P, Huelskamp AM: Breast self-examination proficiency and training effects: Women at increased risk of breast cancer. Cancer Epidemiol Biomarkers Prev 1:591–596, 1992

    Google Scholar 

  21. Costanza ME, Stoddard A, Gaw VP, Zapka JG: The risk factors of age and family history and their relationship to screening mammography utilization. J Am Geriatr Soc 40:774–778, 1992

    Google Scholar 

  22. Taplin S, Anderman C, Grothaus L: Breast cancer risk and participation in mammographic screening. Am J Publ Health 79:1494–1498, 1989

    Google Scholar 

  23. Hailey BJ: Family history of breast cancer and screening behavior: An inverted U-shaped curve? Med Hypotheses 36:397–402, 1991

    Google Scholar 

  24. Lerman C, Trock B, Rimer B, Jepson C, Brody D, Boyce A: Psychological side effects of breast cancer screening. Health Psychol 10:259–267, 1991

    Google Scholar 

  25. Lerman C, Trock B, Rimer BK, Boyce A, Jepson C, Engstrom PF: Psychological and behavioral implications of abnormal mammograms. Ann Intern Med 114:657–661, 1991

    Google Scholar 

  26. Janis IL, Feshbach S: Effects of fear-arousing communications. J Abnorm Soc Psychol 48:78–92, 1953

    Google Scholar 

  27. Horowitz M, Wilner N, Alvarez W: Impact of Event Scale: A measure of subjective stress. Psychosom Med 41:209–218, 1979

    Google Scholar 

  28. Wellisch DK, Gritz ER, Schain W, et al: Psychological functioning of daughters of breast cancer patients. I: Daughters and comparison subjects. Psychosomatics 32:324–336, 1991

    Google Scholar 

  29. McNair DM, Lorr M, Droppleman LF: Profile of mood states manual. Educational & Industrial Testing Service, San Diego, 1971

    Google Scholar 

  30. Lerman C, Daly M, Walsh WP, Resch N, Seay J, Barsevick A, Birenbaum L, Heggan T, Martin G: Breast cancer patient-provider communication: Determinants and implications. Cancer (in press)

  31. Ganz PA, Schag CAC, Lee JJ, Polinsky ML, Tan SJ: Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year of the surgery? Cancer 69: 1729–1738, 1992

    Google Scholar 

  32. Wolberg WH, Romsaas EP, Tanner MA, Malec JF: Psychosexual adaptation to breast cancer surgery. Cancer 63:1645–1655, 1989

    Google Scholar 

  33. Lazarus RS, Folkman S: Stress, Appraisal, and Coping. Springer, New York, 1984

    Google Scholar 

  34. Glanz K, Lerman C: Psychosocial impact of breast cancer: A critical review. Ann Behav Med 14:204–212, 1992

    Google Scholar 

  35. Stanton AL, Snider PR: Coping with a breast cancer diagnosis: A prospective study. Health Psychol 12:16–23, 1993

    Google Scholar 

  36. Lerman C, Bookman M: Counseling women at high risk for breast cancer. Primary Care and Cancer (in press)

  37. Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being screened annually. JNCI 81:1879–1886, 1989

    Google Scholar 

  38. Lerman C, Rimer BK, Engstrom PF: Cancer risk notification: Psychosocial and ethical implications. J Clin Oncol 9:1275–1282, 1991

    Google Scholar 

  39. Lerman C, Ross E, Boyce A, McGovern Gorchov P, McLaughlin R, Rimer B, Engstrom P: The impact of mailing psychoeducational materials to women with abnormal mammograms. Am J Publ Health 82:729–730, 1992

    Google Scholar 

  40. Paskett ED, White E, Carter WB, et al: Improving follow-up after an abnormal pap smear: A randomized controlled trial. Prev Med 19:630–641, 1990

    Google Scholar 

  41. Wilkinson C, Jones JM, McBride J: Anxiety caused by abnormal result of cervical smear test: A controlled trial. Br Med J 300:440, 1990

    Google Scholar 

  42. Lerman C, Hanjani P, Caputo C, Miller S, Delmoor E, Nolte S, Engstrom P: Telephone counseling improves adherence to colposcopy among lower-income minority women. J Clin Oncol 10:330–333, 1992

    Google Scholar 

  43. Miller SM, Mangan CE: Interacting effects of information and coping style in adapting to gynecologic stress: Should the doctor tell all? J Pers Soc Psychol 45:223–236, 1983

    Google Scholar 

  44. Vogel VG: High-risk populations as targets for breast cancer prevention trials. Prev Med 20:86–100, 1991

    Google Scholar 

  45. Nayfield SG, Karp JE, Ford LG, Dorr FA, Kramer BS: Potential role of tamoxifen in prevention of breast cancer. JNCI 83:1450–1459, 1991

    Google Scholar 

  46. Rimer BK, Engstrom PF: Participation in macronutrient trials.In: Micozzi MS, Moon TE (eds) Macronutrients: Investigating Their Role in Cancer. M Dekker, Inc, New York, 1992, pp 437–467

    Google Scholar 

  47. Daly M, Seay J, Balshem A, Lerman C, Engstrom P: Feasibility of a telephone survey to recruit health maintenance organization members into a tamoxifen chemoprevention trial. Cancer Epidemiol Biomarkers Prev 1:413–416, 1992

    Google Scholar 

  48. King MC, Rowell S, Love SM: Inherited breast and ovarian cancer: What are the risks? What are the choices? JAMA 269:1975–1980, 1993

    Google Scholar 

  49. Hall JM, Friedman L, Guenther C, et al: Closing in on a breast cancer gene on chromosome 17q. Am J Hum Genet 50:1235–1242, 1992

    Google Scholar 

  50. Easton DF, Bishop DT, Ford D, Crockford GP, and the Breast Cancer Linkage Consortium: Genetic linkage analysis in familial breast and ovarian cancer: Results from 214 families. Am J Hum Genet 52:678–701, 1993

    Google Scholar 

  51. Lynch HT, Watson P, Conway TA, Lynch JF, Slominski-Caster SM, Narod SA, Feunteun J, Lenoir G: DNA screening for breast/ ovarian cancer susceptibility based on linked markers: A family study. Arch Int Med (in press)

  52. Biesecker BB, Boehnke M, Calzone K, Markel DS, Garber JE, Collins FS, Weber BL: Genetic counseling for families with inherited susceptibility to breast and ovarian cancer. JAMA 269:1970–1974, 1993

    Google Scholar 

  53. Croyle R, Lerman C: Psychological impact of genetic testing.In: Croyle R (ed) Psychosocial Effects of Screening for Disease Prevention and Detection. Oxford University Press, New York (in press)

  54. Wiggins S, Whyte P, Huggins M, Adam S, Theilman J, Block M, Sheps SB, Schechter MT, Hayden MR: The psychological consequences of predictive testing for Huntington's disease. N Engl J Med 327:1401–1405, 1992

    Google Scholar 

  55. Tobacman JK, Greene MH, Tucker MA, Costa J, Kase R, Fraumeni JF: Intra-abdominal carcinomatosis after prophylactic oophorectomy in ovarian-cancer-prone families. Lancet ii: 795–797, 1982

    Google Scholar 

  56. Croyle RT, Jemmott JB III: Psychological reactions to risk factor testing.In: Skelton JA, Skelton RT (eds) Mental Representation in Health and Illness. Springer-Verlag, New York, 1991

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Fox Chase Cancer Center, Population Science Division, Philadelphia, PA, USA

    Caryn Lerman Ph.D. & Marc Schwartz Ph.D.

  2. Vincent T. Lombardi Cancer Center, Georgetown University School of Medicine, 2233 Wisconsin Avenue NW, Suite 210, 20007, Washington DC, USA

    Caryn Lerman Ph.D.

Authors
  1. Caryn Lerman Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc Schwartz Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lerman, C., Schwartz, M. Adherence and psychological adjustment among women at high risk for breast cancer. Breast Cancer Res Tr 28, 145–155 (1993). https://doi.org/10.1007/BF00666427

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00666427

Key words

Search

Navigation