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

• Published in: Journal of surgical oncology Vol. 116; no. 8; pp. 1029 - 1039
• Main Authors: Wevers, Marijke R., Aaronson, Neil K., Bleiker, Eveline M. A., Hahn, Daniela E. E., Brouwer, Titia, van Dalen, Thijs, Theunissen, Evert B., van Ooijen, Bart, de Roos, Marnix A., Borgstein, Paul J., Vrouenraets, Bart C., Vriens, Eline, Bouma, Wim H., Rijna, Herman, Vente, Johannes P., Kuenen, Marianne A., van der Sanden‐Melis, Jacoline, Witkamp, Arjen J., Rutgers, Emiel J. Th, Verhoef, Senno, Ausems, Margreet G. E. M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 15.12.2017
• Subjects: BRCA1; BRCA2; Breast cancer; Cancer surgery; Genetic counseling; genetic counseling and testing; patient empowerment; Surgeons; breast cancer; patient empowerment; BRCA1; BRCA2; genetic counseling and testing
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.24763

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.