The psychological impact and experience of breast cancer screening in young women with an increased risk of breast cancer due to neurofibromatosis type 1

Women with neurofibromatosis type 1 (NF1) have an increased risk of developing early breast cancer with a poorer prognosis compared to the general population. Therefore, international management guidelines recommend regular screening in women with NF1 starting from 30 to 35 years. As the psychological impacts of breast cancer screening in other high-risk populations cannot be extended to women with NF1, due to increased incidence of cognitive and mental health issues, the psychological harms of breast screening in women with NF1 are unknown. Consequently, the aim of this study was to assess the psychological impact of breast cancer screening in women with NF1 attending an established risk management clinic. Twenty-eight women with NF1 (30–50 years) completed psychological well-being and patient experience questionnaires, administered across five time points, before and after their initial and second round annual breast screening visits. Preliminary findings demonstrated the screening regimen was well-tolerated, with most participants reporting high satisfaction with the screening process. Overall, no significant increase in psychological distress related to the breast screening process was identified, with mean cancer worry and anxiety scores decreasing over time. However, some women did experience negative aspects of screening and barriers to re-attendance at annual breast screening appointments. As some women with NF1 exhibited clinical levels of psychological distress prior to screening, efforts to identify those at risk and additional support to address concerns and expectations throughout the breast screening process may be beneficial.

Acetylation phenotype in colorectal carcinoma

Sulfamethazine acetylation phenotype was determined in 49 patients with cancer of the colon or rectum, 41 old, and 45 young control subjects. Metabolic clearance of sulfamethazine, plasma ratio of N-acetylsulfamethazine:N-acetylsulfamethazine plus sulfamethazine and urinary ratio of N-acetylsulfamethazine:N-acetylsulfamethazine plus sulfamethazine were used to classify subjects into slow and fast acetylation phenotypes. All three measures gave similar results. The proportions of slow and fast acetylators were similar in both control groups and there were significantly more fast acetylators in the cancer group than in the control groups (chi 2 = 5.0-8.5; P less than 0.05). The data suggest that there may be an association between acetylation phenotype and colorectal carcinoma.