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Too Few Early Breast CA Patients Given Formal Genetic Counseling

43.5% of women with early-stage breast cancer with indications for risk evaluation get counseling

WEDNESDAY, March 14, 2018 (HealthDay News) — Many women with early-stage breast cancer with indications for formal genetic risk evaluation do not receive formal counseling, according to a study published online March 12 in the Journal of Clinical Oncology.

Steven J. Katz, M.D., M.P.H., from the University of Michigan Health Systems in Ann Arbor, and colleagues surveyed 5,080 patients aged 20 to 79 years diagnosed from July 2013 to August 2015 with early-stage breast cancer. Data were included for 1,711 patients with indications for formal genetic risk evaluation.

The researchers found that 47.4 percent of participants did not get tested, while 40.7, 7.4, and 4.5 percent tested negative, had a variant of uncertain significance, and had a pathogenic mutation, respectively. Overall, 74.6 percent received some form of genetic counseling (43.5 and 31.1 percent received formal counseling and physician-directed discussion, respectively). Almost all tested patients (96.1 percent) received some form of genetic discussion; only 50.6 percent of those not tested received any genetics discussion. Some form of counseling was more likely to be reported by younger women, with odds ratios of 4.5, 1.9, and 1.5, respectively, for women aged younger than 50 years, 50 to 59 years, and 60 to 69 years versus those aged ≥70 years, after adjustment for other factors.

“There is a large gap between mandates for timely pretest formal genetic counseling in higher-risk patients and the reality of practice today,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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