Receipt of Genetic Testing After Breast Cancer Diagnosis May Be Affected by Surgeon
Posted: Monday, August 13, 2018
The rate of patients receiving genetic testing after a diagnosis of breast cancer is associated with the presence of surgeons, reported a population-based study conducted by Steven J. Katz, MD, MPH, of the University of Michigan Medical School and published in JAMA Surgery. Finding surgeons’ attitudes toward testing to vary widely as well, the authors suggest a need for more research and better guidelines.
“The surge of genetic testing into cancer care is a major challenge for surgeons,” stated Dr. Katz and colleagues. “Our results highlight the need for greater outreach to surgeons in the community to build consensus about approaches to genetic risk evaluation and results management for patients with breast cancer, particularly as evidence emerges about the utility of genetic testing in clinical and demographic subgroups.”
The study contained cases from the Surveillance, Epidemiology, and End Results and genetic testing data from four laboratories. More than 7,000 women with breast cancer were sent questionnaires, and more than half (3,910) responded. The investigators linked the respondents with 370 respondent surgeons. The mean years of practice for the surgeons was 20.9 years, and 28.9% treated more than 50 new breast cancer cases each year.
Of the total patients surveyed, 34.3% had an elevated risk of carrying a genetic mutation, and 27% had genetic testing. The study found multiple factors for the different rates of testing. The attending surgeon accounted for 17.4% of the variation in testing. The patients with an elevated risk of a genetic mutation were more likely to receive testing, and surgeons who treated more patients with breast cancer were more likely to recommend testing.