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

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

Marijke R Wevers  1   2 , Neil K Aaronson  1 , Eveline M A Bleiker  1 , Daniela E E Hahn  3 , Titia Brouwer  2 , Thijs van Dalen  4 , Evert B Theunissen  5 , Bart van Ooijen  6 , Marnix A de Roos  7 , Paul J Borgstein  8 , Bart C Vrouenraets  9 , Eline Vriens  10 , Wim H Bouma  11 , Herman Rijna  12 , Johannes P Vente  13 , Marianne A Kuenen  1 , Jacoline van der Sanden-Melis  2 , Arjen J Witkamp  14 , Emiel J Th Rutgers  15 , Senno Verhoef  16 , Margreet G E M Ausems  2
Affiliations

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

Marijke R Wevers et al. J Surg Oncol. 2017 Dec.

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.

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