Study: Impact of familial breast cancer risk on young girls

IN DEPTH REVIEW OF RESEARCH

Study background:

While previous studies looked at children’s response to having parents with cancer, few have studied how being from a family with a genetic or familial risk for breast cancer impacts children. Although results from studies of children with parents who have cancer suggest that these children may be at risk for internalizing and externalizing problems and general distress, the studies were often small and did not include a comparison group. It is important to understand how children are coping because research has shown that psychosocial distress can be associated with greater risk behaviors, such as alcohol and tobacco use.  In this study, Dr. Angela Bradbury and colleagues at the University of Pennsylvania and the Children’s Hospital of Philadelphia looked at signs of distress in girls who were from families at high risk for breast cancer. 

Researchers of this study wanted to know:

Do young girls with a family history of breast cancer or BRCA mutation have worse psychosocial adjustment (internalizing and externalizing problems and breast cancer-specific stress), higher risk taking, and lower preventive health behaviors than young girls without a familial breast cancer risk?
What factors are associated with higher perceived risk of breast cancer?

Population(s) looked at in the study:

The study included 869 mother-daughter pairs (441 pairs were from families with a history of breast cancer, while 428 were not). Daughters ranged from ages 6 to 13.  Participants were from 5 U.S. study sites in these states: New York City, Philadelphia, Salt Lake City, the San Francisco Bay Area, and Canada (Ontario). Among the 441 mothers in the group with family history of breast cancer:

• about 40% had a personal history of breast cancer.
• about 14% had BRCA mutations.

The researchers assessed information that was gathered from surveying the mothers in each pair.  Girls who were age 10 and older also self-reported information, while girls who were under age 10 did not.

The criteria for participating mothers and daughters with familial breast cancer risk was defined as having more than 1 close first- or second-degree relative (parent, child, sibling, grandparent, aunt or uncle) with breast cancer or a BRCA mutation. The comparison group did not have a family history of breast cancer or a BRCA mutation. 

Study findings: 

1. The more relatives who had breast cancer, the higher young girls perceived their risk.
2. Higher general anxiety in daughters was associated with higher anxiety in their mothers, in addition to poor family communication.
3. Girls from a family with familial risk were more likely to report that they had increased risk for breast cancer.
4. Girls in both groups (those with and without familial risk for breast cancer), were unsure of their exact risk.

Limitations:

This study only looked at mother-daughter pairs: there was no data on daughters with a deceased mother. Nor did the study take into account the impact of fathers. The study population of BRCA families was small.

Conclusions:

Being aware of how breast cancer impacts daughters in families with familial breast cancer risk is important. This study shows that daughters from these families are generally well adjusted, although they do have greater breast cancer-specific distress and anxiety, and perceive higher breast cancer risk.  Being aware of this can help health care providers determine interventions to address concerns of both mother and daughter.  Members of our advisory board also note that although the children in this study did not necessarily feel more distress than their peers, parents should remember that every daughter and every family is unique.  Parents should be alert for any changes in a child's typical behavior, such as sleep changes, worry, and/or a drop in school grades. It is important for parents to monitor their daughters’ behavior, open dialogue with them, and get help if they believe their daughter is not coping well.  

Published 11/03/15

(back to top)