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    <title>Lodder, L.N.</title>
    <link>http://repub.eur.nl/res/aut/3055/</link>
    <description>List of Publications</description>
    <language>en</language>
    <image>
      <url>http://repub.eur.nl/static-eur/img/logo.png</url>
      <title>RePub, Erasmus University Rotterdam</title>
      <link>http://repub.eur.nl</link>
    </image>
    <item>
      <title>Dealing with the Risk for Hereditary Breast and Ovarian Cancer (Doctoral Thesis)</title>
      <link>http://repub.eur.nl/res/pub/13815/</link>
      <pubDate>2001-11-01T00:00:00Z</pubDate>
      <description></description>
    </item> <item>
      <title>Presymptomatic testing for BRCA1 and BRCA2: how distressing are the pre-test weeks? Rotterdam/Leiden Genetics Working Group (Article)</title>
      <link>http://repub.eur.nl/res/pub/9211/</link>
      <pubDate>1999-01-01T00:00:00Z</pubDate>
      <description>Presymptomatic DNA testing for autosomal dominant hereditary
          breast/ovarian cancer (HBOC) became an option after the identification of
          the BRCA1 and BRCA2 genes in 1994-1995. Healthy female mutation carriers
          have a high lifetime risk for breast cancer (56-87%) or ovarian cancer
          (10-60%) and may opt for intensive breast and ovary surveillance or
          prophylactic surgery (mastectomy/oophorectomy).We studied general and
          cancer related distress in 85 healthy women with a 25% or 50% risk of
          being carrier of a BRCA1/BRCA2 gene mutation and 66 partners in the six to
          eight week period between genetic counselling/blood sampling and
          disclosure of the test result. Questionnaire and interview data are
          analysed. Associations are explored between levels of distress and (1)
          expected consequences of being identified as a mutation carrier, (2)
          personality traits, (3) sociodemographic variables, and (4) experiences
          related to HBOC.Mean pre-test anxiety and depression levels in women at
          risk of being a carrier and partners were similar to those of a normal
          Dutch population. In about 25% of those at risk of being a carrier and 10%
          of the partners, increased to high levels of general and cancer related
          distress were found. Increased levels of distress were reported by women
          who (1) anticipated an increase in problems after an unfavourable test
          outcome, (2) considered prophylactic mastectomy if found to be mutation
          carrier, (3) had an unoptimistic personality, (4) tended to suppress their
          emotions, (5) were younger than 40 years, and (6) were more familiar with
          the serious consequences of HBOC. Recently obtained awareness of the
          genetic nature of cancer in the family was not predictive of distress.The
          majority of the women and their partners experienced a relatively calm
          period before the disclosure of the test result and seemed to postpone
          distressing thoughts until the week of disclosure of the result. The low
          distress levels may partly be explained by the use of strategies to
          minimise the emotional impact of a possibly unfavourable test outcome.
          However, a minority reported feeling very distressed. Several factors were
          found to be predictive for increased distress levels.</description>
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