Genetic counseling, testing and family communication into survivorship after diagnosis of breast cancer

Details

• Alternative Title:
  J Clin Oncol
• Personal Author:
  Katz, Steven J. ; Abrahamse, Paul ; Furgal, Allison ; Hodan, Rachel ; Tocco, Rachel S. ; Ward, Kevin C. ; Hamilton, Ann S. ; Wallner, Lauren P. ; Kurian, Allison W.
• Description:
  Purpose:
  
  To examine receipt of genetic testing and communication with relatives about results into survivorship after diagnosis of breast cancer.
  
  Patients and methods:
  
  Women aged 20–79 diagnosed with early-stage breast cancer in 2014–2015 and reported to the Georgia and Los Angeles County SEER registries were surveyed approximately seven months and six years after diagnosis (N=1412). We asked about genetic counseling, testing, and communication with relatives about results. We categorized women into indications for testing based on clinical guidelines at time of diagnosis and at the time of the follow-up survey.
  
  Results:
  
  47.4% had indications for genetic testing at any time: 28.0% at baseline and an additional 19.4% at time of the follow-up survey (FUPs only); 71.9% (95% CI 67.4%−76.4%) of those with a baseline indication reported genetic testing vs. 53.3% (95% CI 47.3% - 59.2%) with an indication at FUPs only and 35.0% (95% CI 31.6% - 38.4%) with no indication (p<.001). There were no significant racial or ethnic differences in receipt of testing, controlling for age and clinical indications (p=0.239); results for genetic counseling were similar. Only 3.4% of survivors had direct-to-consumer testing (DTCt) for cancer. Testers who reported a pathogenic variant (n=62) were much more likely to have talked to most or all their first-degree adult relatives about genetic testing than those with a variant of unknown significance (n=49) or a negative finding (n=419): 62.7% vs 38.8% and 38.0%, respectively (p<.001).
  
  Conclusion:
  
  Many women with indications for genetic counseling and testing into survivorship do not receive it. But those tested reach out to family members based on the clinical relevance of their results. Very few patients obtained DTCt, which suggests that these tests do not substitute for clinical testing in breast cancer survivors.
  
  
• Subjects:
  Adult Aged Breast Neoplasms Cancer Survivors Communication Family Female Genetic Counseling Genetic Testing Georgia Humans Middle Aged SEER Program Survivorship Young Adult

  More +
• Source:
  J Clin Oncol. 42(26):3123-3129
• Pubmed ID:
  39008790
• Pubmed Central ID:
  PMC11377164
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; P30 CA046592/CA/NCI NIH HHSUnited States/ ; P01 CA163233/CA/NCI NIH HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; HHSN261201800003C/CA/NCI NIH HHSUnited States/
• Volume:
  42
• Issue:
  26
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:5f13de47d948efb0a34cc5a107df3d787fe3f54386fea0a8b6d7f011aedf13b4bbc8b52b6013ab831d7180f5cb4c08b4df72125e57708b96f55bf5448b4e899a
• Download URL:
  https://stacks.cdc.gov/view/cdc/162375/cdc_162375_DS1.pdf
• File Type:
  [PDF - 273.60 KB ]