Knowledge regarding and patterns of genetic testing in patients newly diagnosed with breast cancer participating in the iCanDecide trial

Cancer. 2018 Oct 15;124(20):4000-4009. doi: 10.1002/cncr.31731. Epub 2018 Oct 5.

Abstract

Background: The current study reports rates of knowledge regarding the probability of a BRCA1 and/or S pathogenic variant and genetic testing in patients with breast cancer, collected as part of a randomized controlled trial of a tailored, comprehensive, and interactive decision tool (iCanDecide).

Methods: A total of 537 patients newly diagnosed with early-stage breast cancer were enrolled at the time of their first visit in 22 surgical practices, and were surveyed 5 weeks (496 patients; Response Rate [RR], 92%) after enrollment after treatment decision making. Primary outcomes included knowledge regarding the probability of carrying a BRCA1 and/or BRCA2 pathogenic variant and genetic testing after diagnosis.

Results: Overall knowledge regarding the probability of having a BRCA1 and/or BRCA2 pathogenic variant was low (29.8%). Significantly more patients in the intervention group compared with the control group had knowledge regarding the probability of a BRCA1 and/or BRCA2 pathogenic variant (35.8% vs 24.4%; P <.006). In multivariable logistic regression, the intervention arm remained significantly associated with knowledge regarding the probability of having a BRCA1 and/or BRCA2 pathogenic variant (odds ratio, 1.79; 95% confidence interval, 1.18-2.70).

Conclusions: The results of the current study suggest that although knowledge concerning the probability of having a BRCA1 and/or BRCA2 pathogenic variant remains low in this patient population, the interactive decision tool improved rates compared with a static Web site. As interest in genetic testing continues to rise, so will the need to integrate tools into the treatment decision process to improve informed decision making.

Keywords: BRCA1 and/or BRCA2; breast cancer patients; decision making; decision tool; diagnosis; genetic testing; knowledge; probability information.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / genetics
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / genetics
  • Breast Neoplasms / psychology
  • Breast Neoplasms / therapy*
  • Choice Behavior
  • Critical Pathways* / organization & administration
  • Critical Pathways* / standards
  • DNA Mutational Analysis / methods
  • DNA Mutational Analysis / psychology
  • Decision Making*
  • Female
  • Gene Expression Regulation, Neoplastic
  • Genes, BRCA1
  • Genes, BRCA2
  • Genetic Counseling
  • Genetic Testing* / methods
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Middle Aged
  • Patient Participation / methods*
  • Patient Portals* / standards
  • Precision Medicine / methods
  • Precision Medicine / psychology
  • Transcriptome / physiology
  • Young Adult

Substances

  • Biomarkers, Tumor