Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul;18(3):293-301.
doi: 10.1007/s10689-019-00122-y.

Moving into the mainstream: healthcare professionals' views of implementing treatment focussed genetic testing in breast cancer care

Nina Hallowell  1 , S Wright  2 , D Stirling  3 , C Gourley  3   4 , O Young  5 , M Porteous  3
Affiliations

Moving into the mainstream: healthcare professionals' views of implementing treatment focussed genetic testing in breast cancer care

Nina Hallowell et al. Fam Cancer. 2019 Jul.

Abstract

A proportion of breast cancers are attributable to BRCA1 or BRCA2 mutations. Technological advances has meant that mutation testing in newly diagnosed cancer patients can be used to inform treatment plans. Although oncologists increasingly deliver treatment-focused genetic testing (TFGT) as part of mainstream ovarian cancer care, we know little about non-genetics specialists' views about offering genetic testing to newly diagnosed breast cancer patients. This study sought to determine genetics and non-genetics specialists' views of a proposal to mainstream BRCA1 and 2 testing in newly diagnosed breast cancer patients. Qualitative interview study. Nineteen healthcare professionals currently responsible for offering TFGT in a standard (triage + referral) pathway (breast surgeons + clinical genetics team) and oncologists preparing to offer TFGT to breast cancer patients in a mainstreamed pathway participated in in-depth interviews. Genetics and non-genetics professionals' perceptions of mainstreaming are influenced by their views of: their clinical roles and responsibilities, the impact of TFGT on their workload and the patient pathway and the perceived relevance of genetic testing for patient care in the short-term. Perceived barriers to mainstreaming may be overcome by: more effective communication between specialities, clearer guidelines/patient pathways and the recruitment of mainstreaming champions.

Keywords: BRCA1 and BRCA2 treatment focussed testing; Clinician perspectives; Mainstreaming; Qualitative analysis.

PubMed Disclaimer

Conflict of interest statement

SW, MP, DS, JL, OY, and NH declare that they have no conflict of interest. CG has sat on Advisory Boards for AstraZeneca, Clovis and Tesaro, has received lecture fees and research funding from AstraZeneca and Tesaro.

Figures

Fig. 1
Fig. 1
Current and proposed breast cancer care pathways at study site. Shaded area indicates tasks undertaken by clinical genetics team
See this image and copyright information in PMC

References

    1. Claus EB, Schildkraut JM, Thompson WD, et al. The genetic attributable risk of breast and ovarian cancer. Cancer. 1996;77:2318–2324. doi: 10.1002/(SICI)1097-0142(19960601)77:11<2318::AID-CNCR21>3.0.CO;2-Z. - DOI - PubMed
    1. Zhang S, Royer R, Li S, et al. Frequencies of BRCA1 and BRCA2 mutations among 1,342 unselected patients with invasive ovarian cancer. Gynecol Oncol. 2011;121:353–357. doi: 10.1016/j.ygyno.2011.01.020. - DOI - PubMed
    1. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017;317:2402–2416. doi: 10.1001/jama.2017.7112. - DOI - PubMed
    1. Haffty BG, Harrold E, Khan AJ, et al. Outcome of conservatively managed early-onset breast cancer by BRCA1/2 status. Lancet. 2002;359:1471–1477. doi: 10.1016/S0140-6736(02)08434-9. - DOI - PubMed
    1. National Institute for Health and Clinical Excellence (2013) Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer. NICE guideline [CG164]. National Institute for Health and Clinical Excellence - PubMed

Publication types