Stephanie A. Cohen, MS, LCGC from Ascension St. Vincent discusses the ACCC/ASCO 2020 abstract - [Abstract #1526] BRCA Testing Concordance with National Guidelines for Patients with Breast Cancer in Community Cancer Programs.
Current National Comprehensive Cancer Network recommendations note that for women diagnosed with early-onset (about 45 years), later age (having met ethnic or family history criteria), or metastatic HER-2 negative breast cancer, checking for extremely penetrating breast/ovarian cancer genes is clinically suggested.
A recent survey by the Association of Community Cancer Centers (ACCC) (N = 95) found that > 80 percent of respondents registered > 50% test rates for breast cancer patients who met the criteria for testing.
In view of this disconnection, ACCC collaborated with 15 regional cancer initiatives to evaluate practice gaps and encourage strategies to increase access to genetic counseling (GC)/testing.
Via quality enhancement measures, to increase rates of guideline-concordant BRCA testing for breast cancer patients in community cancer programs.
Pre-intervention data were obtained for 2691 women diagnosed with stage 0-III breast cancer between 01/01/2017 and 06/30/2019 from 9/15 active cancer programs.
De-identified variables included: documentation of family history, GC appointment/test results, and timing of outcomes relative to decisions on surgical care.
Forty-eight percent (1284/2691) had a recorded family history of high risk, of which 57 percent (729/1284) had a GC appointment.
This was, as predicted, a significantly higher GC rate compared to 23% (181/778) of those with negative family history and 6% (35/629) of those with no recorded family history (p < 0.0001).
In this collective cohort of women with breast cancer, genetic testing is underused.
Fifty-seven percent of reported cases with a
Genetic therapy was conducted on high-risk family histories; 23 percent of those with a negative family
History's got GC.
Thirty-seven percent of women who presented preoperative test results had breast preservation.
Compared to 60 percent of women with research, surgery
Post-operatively disclosed outcomes.
Further work is needed to comprehend decisions
Genetic testing and the timing of said genetic testing
Surgical Decision Making Research.
There are ways to evaluate facilitators and
Obstacles to genetic services dependent on the culture in
To improve access to guideline-based GC/GC/GC