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Oonk AMM, Ariens S, Kunst HPM, Admiraal RJC, Kremer H, Pennings RJE. Psychological impact of a genetic diagnosis on hearing impairment-An exploratory study. Clin Otolaryngol 2017; 43:47-54. [PMID: 28556609 DOI: 10.1111/coa.12908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Genetic testing for hereditary hearing impairment has become more routinely available as a diagnostic tool in the outpatient clinic. However, little is known about the psychological impact of a genetic diagnosis. To evaluate this impact, an exploratory study was conducted. DESIGN Prospectively, 48 individuals who underwent genetic testing for hereditary hearing impairment were included in this study. Study participants were asked to fill out the following questionnaires: Hospital Anxiety Depression Scale, Impact of Event Scale, Self-Efficacy 24, Illness Cognition Questionnaire and the Inventory for Social Reliance. Questionnaires were filled out on three occasions: before genetic testing, directly after counselling on either positive or negative test results, and six weeks thereafter. RESULTS No significant differences were found between the group that received a genetic diagnosis for their hearing impairment and the group that did not. CONCLUSION This study did not demonstrate differences between receiving a genetic diagnosis or not; however, special attention to psychological well-being should be offered to hearing-impaired patients who seek a genetic diagnosis for their hearing impairment. Additionally, the psychological impact of sensorineural hearing impairment might be greater than the impact of a genetic diagnosis itself. Based on the current exploratory study, there are no psychological reasons in favour of or against genetic testing for hereditary hearing impairment.
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Affiliation(s)
- A M M Oonk
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - S Ariens
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H P M Kunst
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - R J C Admiraal
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - H Kremer
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R J E Pennings
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Oonk AMM, Huygen PLM, Kunst HPM, Kremer H, Pennings RJE. Features of autosomal recessive non-syndromic hearing impairment: a review to serve as a reference. Clin Otolaryngol 2016; 41:487-97. [PMID: 26474130 DOI: 10.1111/coa.12567] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Non-syndromic sensorineural hearing impairment is inherited in an autosomal recessive fashion in 75-85% of cases. To date, 61 genes with this type of inheritance have been identified as related to hearing impairment, and the genetic heterogeneity is accompanied by a large variety of clinical characteristics. Adequate counselling on a patient's hearing prognosis and rehabilitation is part of the diagnosis on the genetic cause of hearing impairment and, in addition, is important for the psychological well-being of the patient. TYPE OF REVIEW Traditional literature review. DATA SOURCE All articles describing clinical characteristics of the audiovestibular phenotypes of identified genes and related loci have been reviewed. CONCLUSION This review aims to serve as a summary and a reference for counselling purposes when a causative gene has been identified in a patient with a non-syndromic autosomal recessively inherited sensorineural hearing impairment.
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Affiliation(s)
- A M M Oonk
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands. .,Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - P L M Huygen
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H P M Kunst
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H Kremer
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Nijmegen Centre for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R J E Pennings
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Oonk AMM, Beynon AJ, Peters TA, Kunst HPM, Admiraal RJC, Kremer H, Verbist B, Pennings RJE. Vestibular function and temporal bone imaging in DFNB1. Hear Res 2015; 327:227-34. [PMID: 26188104 DOI: 10.1016/j.heares.2015.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 06/30/2015] [Accepted: 07/12/2015] [Indexed: 10/23/2022]
Abstract
DFNB1 is the most prevalent type of hereditary hearing impairment known nowadays and the audiometric phenotype is very heterogeneous. There is, however, no consensus in literature on vestibular and imaging characteristics. Vestibular function and imaging results of 44 DFNB1 patients were evaluated in this retrospective study. All patients displayed a response during rotational velocity step testing. In 65% of the cases, the caloric results were within normal range bilaterally. The video head impulse test was normal in all patients. In 34.4% of the CT scans one or more temporal bone anomalies were found. The various anomalies found, were present in small numbers and none seemed convincingly linked to a specific DFNB1genotype. The group of DFNB1 patients presented here is the largest thus far evaluated for their vestibular function. From this study, it can be assumed that DFNB1 is not associated with vestibular dysfunction or specific temporal bone anomalies.
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Affiliation(s)
- A M M Oonk
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - A J Beynon
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - T A Peters
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Nijmegen Centre for Molecular Life Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - H P M Kunst
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - R J C Admiraal
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - H Kremer
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Nijmegen Centre for Molecular Life Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Department of Human Genetics, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - B Verbist
- Department of Radiology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - R J E Pennings
- Department of Otorhinolaryngology, Hearing & Genes, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Oonk AMM, van Rijn C, Smits MM, Mulder L, Laddach N, Savola SP, Wesseling J, Rodenhuis S, Imholz ALT, Lips EH. Clinical correlates of 'BRCAness' in triple-negative breast cancer of patients receiving adjuvant chemotherapy. Ann Oncol 2012; 23:2301-2305. [PMID: 22357256 DOI: 10.1093/annonc/mdr621] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We have previously reported an array comparative genomic hybridization profile that identifies triple-negative breast cancers (TNBC), with BRCA1 dysfunction and a high sensitivity to intensified dose bifunctional alkylating agents. To determine the effect of conventional-dose chemotherapy in patients with this so-called BRCA1-like profile, clinical characteristics and survival were studied in a large group of TNBC patients. PATIENTS AND METHODS DNA was isolated and BRCA1-like status was assessed in 101 patients with early-stage TNBC receiving adjuvant cyclophosphamide-based chemotherapy. Clinical characteristics and survival were compared between BRCA1-like and non-BRCA1-like groups. Results Sixty-six tumors (65%) had a BRCA1-like profile. Patients with BRCA1-like tumors tended to be younger and had more often node-negative disease (P = 0.06 and P = 0.03, respectively). Five-year recurrence-free survival was 80% for the BRCA1-like group and 75% for the non-BRCA1-like group (P = 0.35). T stage was the only variable significantly associated with survival. CONCLUSIONS BRCA1-like tumors share clinical features, like young age at diagnosis and similar nodal status, with breast cancers in BRCA1 mutation carriers. Their prognosis is similar to that of non-BRCA1-like tumors when conventional-dose chemotherapy is administered. TNBCs that are classified as BRCA1-like may contain a defect in homologous recombination and could, in theory, benefit from the addition of poly ADP ribose polymerase inhibitors.
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Affiliation(s)
| | | | - M M Smits
- Pathology, Deventer Hospital, Deventer
| | - L Mulder
- Departments of Experimental Therapy; Pathology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam
| | | | | | - J Wesseling
- Departments of Experimental Therapy; Pathology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam
| | - S Rodenhuis
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | | | - E H Lips
- Departments of Experimental Therapy; Pathology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam
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Wesseling J, Lips EH, Oonk AMM, Smits RM, van Rijn CCM, Mulder L, Laddach N, Savola SS, Wessels LFA, Nederlof PM, Rodenhuis S, Imholz ALT. PD03-08: BRCA1-Like Triple Negative Tumors: Clinicopathological Variables and Chemosensitivity to Alkylating Agents. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-pd03-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Our group has previously employed array Comparative Genomic Hybridization (aCGH) to assess the genomic patterns of BRCA1-mutated breast cancers. It is reasonable to assume that this pattern indicates ‘BRCAness’ and thus serves as a marker for homologous recombination deficiency. This BRCA1-like aCGH profile is also present in about half of all triple negative sporadic breast cancers and has been shown to be predictive for benefit from intensive chemotherapy with DNA crosslinking agents. To study BRCA1-like tumors and conventional dose chemotherapy sensitivity in more detail, we compared clinical factors and survival rates in a uniform cohort of triple negative breast tumors treated with alkylating agents.
Patients and methods
103 patients with triple negative tumors received conventional dose adjuvant chemotherapy with doxorubicin/cyclophosphamide. DNA was extracted from tumor samples and BRCA1-like profiles were assessed. Tumors were classified as BRCA1 -like or non-BRCA1-like. Standard clinical and histopathological factors were determined and compared between both groups. Relapse free survival (RFS), disease specific survival (DSS) and overall survival (OS) after diagnosis were compared between BRCA1-like and non-BRCA1-like tumors.
Results
66 tumors (65%) had a BRCA1-like profile, while 35 tumors (35%) did not show such a profile. Patients with BRCA1-like tumors tended to be younger and had more often node-negative disease compared to the patients with non-BRCA1-like tumors (p=0.058 and p=0.034, respectively). There was no significant difference in survival between BRCA1-like and non BRCA1-like patients after treatment with alkylating agents: the median RFS was 121 vs. 109 months, median DSS was 129 vs. 114 months and OS was 127 vs. 110 months, for BRCA1-like versus non-BRCA1-like tumors. T-stage was the only variable significantly associated with survival.
Conclusion
BRCA1-like tumors occurred in younger patients and were more often node negative, which are features shared with tumors in BRCA1-mutation carriers. We did not observe a difference in survival between BRCA1-like and non-BRCA1-like triple negative breast cancers after treatment with conventional dose chemotherapy with alkylating agents. These results confirm our previous findings that BRCA1-like tumors have similar sensitivity to anthracycline-based adjuvant chemotherapy as other triple-negative tumors. It will be important to establish whether BRCA1-like tumors also share the exquisite sensitivity of BRCA-mutated tumors to PARP-inhibitors.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD03-08.
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Affiliation(s)
- J Wesseling
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - EH Lips
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - AMM Oonk
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - RM Smits
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - CCM van Rijn
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - L Mulder
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - N Laddach
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - SS Savola
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - LFA Wessels
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - PM Nederlof
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - S Rodenhuis
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
| | - ALT Imholz
- 1Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Deventer Hospital, Deventer, Netherlands; MRC-Holland, Amsterdam, Netherlands
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