Chris Jacobs studentship

Describing and evaluating clinician-patient communication about hereditary breast and ovarian cancer with cancer patients

PhD Student
Chris Jacobs
PhD Supervisor
Professor Susan Michie (UCL)
Funding NIHR Doctoral Research Fellowship
Start and end dates
January 2011 - January 2018

Project details

Advances in genetic testing technology and the ability to target cancer treatment according to genetic profile means that new methods of delivering information about cancer predisposing genes will increasingly be required. In order to inform this process, this PhD project aims to describe and evaluate current practice in clinician-patient communication with women with breast and ovarian cancer about genetic testing for mutations in the breast and ovarian cancer predisposing genes (BRCA1 and BRCA2). The studies are designed to investigate the perspective of families (study 1), health professionals (study 2 and 3) and patients (study 2 and 4). The final study (5) compares the evidence for current practice with published clinical guidelines.

  • Study 1 investigated recall of information about a newly identified pathogenic BRCA1/BRCA2 mutation amongst patients and relatives following genetic counselling. This involved tracking the information communicated in the clinic as it was shared within the family. Accuracy of recall was low, particularly about cancer risks and management options.
  • Study 2 involved a consensus survey of the views of specialist cancer and genetics health professionals and service users with personal experience of breast or ovarian cancer and a BRCA1/BRCA2 mutation. This study aimed to identify the information required by women with breast and ovarian cancer about BRCA1/BRCA2 in order to enable informed decision-making for themselves and their families and the optimal timing of the communication of key messages. The study identified messages agreed as key and not key by each group and areas of agreement and disagreement between the groups.
  • Study 3 investigated the volume and content of the information about BRCA1/ BRCA2 communicated during genetic counselling with women with breast/ ovarian cancer receiving the result of a genetic test. The study investigates which key messages were and were not communicated, the proportion of the total information communicated that was key and the content of the other information communicated.
  • Study 4 is a longitudinal qualitative study with women who learn that their newly diagnosed breast cancer is, or could be, due to a BRCA1/BRCA2 mutation. The methodology used is Interpretative Phenomenological Analysis.
  • Study 5 evaluates the extent to which the guidelines used in current clinical practice in this area are consistent with the evidence of effective practice in order to inform future policy, practice and research in clinician-patient communication with women with hereditary breast and ovarian cancer.