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. 2023 Jun;30(6):3248-3258.
doi: 10.1245/s10434-023-13229-5. Epub 2023 Feb 28.

Surgical Oncologists and Nurses in Breast Cancer Care are Ready to Provide Pre-Test Genetic Counseling

K Bokkers  1 , E M A Bleiker  2   3   4 , C M Aalfs  1 , T van Dalen  5 , M E Velthuizen  1 , P Duijveman  1   6 , R H Sijmons  7 , W Koole  1 , E J P Schoenmaeckers  8 , M G E M Ausems  9
Affiliations

Surgical Oncologists and Nurses in Breast Cancer Care are Ready to Provide Pre-Test Genetic Counseling

K Bokkers et al. Ann Surg Oncol. 2023 Jun.

Abstract

Background: Pre-test genetic counseling for patients with breast cancer is increasingly being provided by nongenetic healthcare professionals. We evaluated the attitudes, knowledge, and self-efficacy of surgeons, oncologists, and nurses regarding mainstream genetic testing and the feasibility to incorporate pre-test genetic counseling into routine care.

Methods: We offered an online training to healthcare professionals from 13 hospitals and implemented a mainstream genetic testing pathway in 11/13 (85%) hospitals. Questionnaires were sent before (T0) and 6 months after (T1) completing the training. Those who did not complete the training received a questionnaire to assess their motivations.

Results: In 11 hospitals, 80 (65%) healthcare professionals completed the training, of whom 70 (88%) completed both questionnaires. The attitudes, (perceived) knowledge and self-efficacy of healthcare professionals were high both at baseline and 6 months after completing the training. After 6 months, their perceived knowledge about the advantages and disadvantages of a genetic test and implications for family members had significantly improved (p = 0.012 and p = 0.021, respectively). For the majority (89%), the time investment for pre-test genetic counseling was less than 15 min per patient and as expected or better. Healthcare professionals considered the total time investment feasible to incorporate mainstream genetic testing into their daily practice. The main barrier to complete the training was lack of time. The online training was considered useful, with a rating of 8/10.

Conclusion: Surgical oncologists and nurses in breast cancer care feel well-equipped and motivated to provide pre-test genetic counseling after completion of an online training module.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow-chart for mainstream genetic testing in patients with breast cancer. HCP healthcare professional, GP general practitioner, VUS variant of uncertain clinical significance aFurther genetic evaluation and/or counseling at the genetics department prior to testing, e.g., for additional genetic testing of the TP53 gene or targeted genetic testing of a known familial pathogenic variant. bReferral to the genetics department for pre-test genetic counseling was optional if requested by the patient or nongenetic healthcare professional (e.g., if the patient had questions that the nongenetic healthcare professional could not answer)
Fig. 2
Fig. 2
Participation of nongenetic healthcare professionals in online training and questionnaire study. HCP healthcare professional aTwo healthcare professionals were not sent the short questionnaire
Fig. 3
Fig. 3
Reasons of nongenetic healthcare professionals for not discussing genetic testing before (T0) and 6 months after completing the online training module (T1), n = 69. Multiple reasons could be given
See this image and copyright information in PMC

Comment in

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