Genetic Testing Guidelines for Patients With Breast Cancer

By: Victoria Kuhr, MS
Posted: Friday, July 26, 2024

Shaili Tapiavala, MD, of Washington University in St. Louis, and colleagues found no significant impact of the American Society of Breast Surgeons (ASBrS) change in genetic testing guidelines on the uptake of genetic testing among patients with breast cancer overall or by socioeconomic factors, family history, breast cancer subtype, age, or insurance status. These findings were presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract e22537). According to the investigators, “multidisciplinary efforts are needed to improve guideline implementation and uptake of genetic testing in breast cancer patients.”

This retrospective cohort study included patients with breast cancer who were diagnosed or treated at the Siteman Cancer Center in St. Louis from January 2017 to December 2020. The preguideline period included patients diagnosed between January 2017 and July 2019, and the postguideline period included those diagnosed with breast cancer between July 2019 and December 2020.

The following data were collected from patients’ electronic medical records: self-reported race/ethnicity, breast cancer subtype (triple-negative breast cancer vs other), insurance type (public vs private), and family history of breast cancer (yes vs no). Additionally, genetic testing rates before and after the guideline change were compared.

A total of 4,386 patients were included in the study. There was no significant difference in the rate of genetic testing among patients with breast cancer before vs after the guideline change (17% vs 14.8%, P = .05). Similarly, there was no significant difference in genetic testing rates before vs after the guideline change for non-Hispanic Black (14.6% vs 13.1%) and non-Hispanic White subgroups (17.8% vs 15.2%). However, patients with a family history of breast cancer (P < .01) and triple-negative breast cancer (P < .01) seemed to be more likely to receive genetic testing, whereas patients older than 50 (P < .001) and those with public insurance were found to be less likely to receive genetic testing (P = .07).

Disclosure: Dr. Tapiavala reported no conflicts of interest. For full disclosures of the other study authors visit coi.asco.org.

2024 ASCO Annual Meeting

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