The study found that the women's beliefs about their inconclusive result had an important impact on their psychological adjustment. "For example, women who report feeling uncertain or ambivalent about their inconclusive DNA test result reported higher levels of worry and distress," Drs. Van Dijk and colleagues write. The women's beliefs about their inconclusive results were "very strongly related" to whether they had come to terms with their result and its implications for breast cancer risk.
The link between beliefs and psychological adjustment remained strong even after accounting for the women's levels of worry and distress. "Cancer-related worries and distress may provide an important but incomplete picture on how women adapt to their inconclusive result," according to the researchers. "[W]omen differ in whether they can cope with the uncertainty of an inconclusive result."
Other important factors included whether the women were actually tested themselves or had received inconclusive results from an affected relative who was tested. Women who were not personally tested were more likely to believe they might have inherited a BRCA mutation, which in turn was related to lower psychological adjustment.
Implications for Genetic Counseling
As in other genetic tests, the psychological impact of BRCA testing is an important consideration. Previous research has found that BRCA testing does not generally lead to high levels of psychological distress. However, few studies have focused on adjustment in the large number of women with inconclusive results.
Dr. van Dijk and colleagues believe their results highlight the role played by genetic counselors in ensuring that women accurately understand their BRCA testincluding the uncertainty associated with inconclusive results. They write, "Not only must women's expecta
|Contact: Kathy Ridgely Beal|
American College of Medical Genetics