Adherence to Intensive Surveillance for Hereditary Breast Cancer
Women at risk for hereditary breast cancer are recommended to undergo intensive surveillance
to maximize the likelihood of detecting the disease at an early, more curable, stage (Burke
et al. 1997, Eisenger et al. 1998, Moller et al. 1999). Although the particular
recommendations of different groups have varied, all suggest programs that incorporate
clinical and radiographic screening performed more frequently than in the general
population, beginning at a considerably younger age. Recent studies demonstrating the
sensitivity of breast MRI have led several groups to incorporate this technology as an
incremental (not replacement) modality, further increasing the intensity of the surveillance
regimen. While data are beginning to accumulate regarding the effectiveness of aggressive
surveillance, little is known about the ability and willingness of women to adhere to these
rigorous schedules, nor about the psychosocial and economic costs of the programs. Based
upon the Cognitive-Social Health Information Processing (C-SHIP)model (Miller, Shoda, Hurley
1996), we hypothesize that the ability to adhere to a proposed screening regimen will result
from a complex and dynamic interaction between the nature of that regimen, events that can
be expected to occur in the course of screening (such as abnormal results and practical
barriers) and key psychological factors such as the individual's attentional style,
affective state, perceived risk of cancer, cancer-specific worries, and beliefs regarding
the effectiveness of screening. To test the hypothesis, we propose to prospectively study
women with a hereditary risk for breast cancer participating in a structured surveillance
program of monthly breast self-examination, semi-annual clinical examination and annual
mammography, augmented by annual interval breast MRI.
Observational
Observational Model: Case-Only, Time Perspective: Prospective
cognitive-affective mediating units that are likely to be involved in health information processing and the execution of health-protective behavior
5 years 7 months
No
Mark Robson, MD
Principal Investigator
Memorial Sloan-Kettering Cancer Center
United States: Food and Drug Administration
03-059
NCT00582803
May 2003
March 2009
Name | Location |
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Memorial Sloan-Kettering Cancer Center | New York, New York 10021 |