Psychosocial predictors of developing breast cancer in women from high risk breast cancer families

对患乳腺癌的社会心理预测因素的文献进行了系统回顾，强调了生活事件和痛苦的可能作用，可能由社会支持和个性介导。迄今为止，对乳腺癌发展中的心理社会因素的前瞻性评估很少。此外，这一领域的研究还没有专门针对因家族史而风险增加的妇女，也没有探讨心理社会因素的影响是否会因基因突变状态而系统性地变化。在过去的5年里，分离两种乳腺癌基因（BRCA1和BRCA2）已经成为可能。这些易感基因突变的女性携带者一生中患乳腺癌的风险估计在37%到85%之间。凯瑟琳·康宁厄姆家族性乳腺癌研究联盟（KConFab）成立于四年前，目的是协调收集具有主要遗传性乳腺癌易感性的澳大利亚家庭的遗传、流行病学和临床数据。由于该人群中乳腺癌和卵巢癌发病率较高，KConFab系统地招募了大量高风险妇女，为在具有足够能力的前瞻性设计中解决有关疾病发展的社会心理预测因素的问题提供了独特和暂时的机会。我们还将能够探索与基因突变状态的相互作用。这项研究将是世界上第一个，并提供迄今为止该领域最严格的数据。如果这项研究证明了心理社会因素与高危家庭妇女乳腺癌的发展之间的关系，那么随后确定易感个体并实施适当的干预措施可能对降低这一人群的发病率和死亡率产生真正的影响。此外，研究结果可能对所有女性降低乳腺癌发病率都有启示意义。

Systematic review of the literature on psychosocial predictors of developing breast cancer has highlighted the possible roles of life events and distress, possibly mediated by social support and personality. To date there has been little prospective assessment of psychosocial factors in the development of breast cancer. Furthermore, no research in this area has specifically targeted women at increased risk because of their family history, nor explored whether the impact of psychosocial factors systematically varies according to genetic mutation status. Over the past 5 years it has become possible to isolate two breast cancer genes (BRCA1 and BRCA2). Female carriers of mutations in these susceptibility genes have an estimated lifetime risk of breast cancer of between 37% and 85%. The Kathleen Cuningham Consortium for Research into Familial Breast Cancer (KConFab) was established four years ago to co-ordinate the collection of genetic, epidemiological and clinical data in Australian families with a dominantly inherited predisposition to breast cancer. The systematic recruitment of large numbers of high risk women by KConFab provides a unique and temporary opportunity to address questions concerning psychosocial predictors of disease development in a prospective design with sufficient power, due to the higher rates of breast and ovarian cancer events in this population. We will also be able to explore interactions with genetic mutation status. The study will be a world first, and provide the most rigorous data to date in this area. If this study demonstrates a relationship between psychosocial factors and the development of breast cancer in women from high risk families, subsequent identification of vulnerable individuals and the implementation of appropriate interventions may have a real impact on reducing morbidity and mortality in this population. Furthermore, the results may have implications for all women in reducing breast cancer incidence.