Rapid genetic counseling and testing in newly diagnosed breast cancer: Patients' and health professionals' attitudes, experiences, and evaluation of effects on treatment decision making

J Surg Oncol. 2017 Dec;116(8):1029-1039. doi: 10.1002/jso.24763. Epub 2017 Jul 13.

Abstract

Background: Rapid genetic counseling and testing (RGCT) in newly diagnosed high-risk breast cancer (BC) patients may influence surgical treatment decisions. To successfully integrate RGCT in practice, knowledge of professionals', and patients' attitudes toward RGCT is essential.

Methods: Between 2008 and 2010, we performed a randomized clinical trial evaluating the impact of RGCT. Attitudes toward and experience with RGCT were assessed in 265 patients (at diagnosis, 6- and 12-month follow-up) and 29 medical professionals (before and after the recruitment period).

Results: At 6-month follow-up, more patients who had been offered RGCT felt they had been actively involved in treatment decision-making than patients who had been offered usual care (67% vs 48%, P = 0.06). Patients who received DNA-test results before primary surgery reported more often that RGCT influenced treatment decisions than those who received results afterwards (P < 0.01). Eighty-seven percent felt that genetic counseling and testing (GCT) should preferably take place between diagnosis and surgery. Most professionals (72%) agreed that RGCT should be routinely offered to eligible patients. Most patients (74%) and professionals (85%) considered surgeons the most appropriate source for referral.

Conclusions: RGCT is viewed as helpful for newly diagnosed high-risk BC patients in choosing their primary surgery and should be offered routinely by surgeons.

Keywords: BRCA1; BRCA2; breast cancer; genetic counseling and testing; patient empowerment.

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / therapy
  • Decision Making
  • Female
  • Genetic Counseling*
  • Genetic Testing*
  • Humans
  • Male
  • Middle Aged
  • Referral and Consultation