Patient Perception, Preferences and Participation Exploring the short-term impact of DNA-testing in breast cancer patients: The counselees' perception matters, but the actual BRCA1/2 result does not

A B S T R A C T Objective: Previous studies suggest that learning a DNA-test-result has no direct impact on the medicaldecisions and psychological well-being of counselees. Their perception, especially their recollections and interpretations of their cancer-risks and heredity, predict and/or mediate this impact. These studies were criticized for their small range of predictors, mediators, outcomes and contextual factors. We studied the short-term impact of DNA-testing with an extended model. Methods: Three months after disclosure of BRCA1/2-test-results, we sent counselees a questionnaire about their perception, medical and psychological outcomes, and medical, familial and psychological contexts. 248 affected women participated; 30 had received pathogenic-mutations, 16 unclassifiedvariants and 202 uninformative-results. Results: The actually communicated genetic-information and the contextual variables predicted the counselees’ perception, but did not directly predict any outcomes. The counselees’ perception predicted and/or completely mediated the counselees’ medical intentions and behavior, physical and psychological life-changes, stigma, mastery, negativity and cancer-worries. Short-term distress was related to the perception not only of their own risks, but also of their relatives’ risks and heredity