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Misunderstanding of BRCA Test Results Affects Mastectomy Rates

THURSDAY, April 13, 2017 -- Close to half of breast cancer patients who choose to have a double mastectomy after genetic testing may not have the gene mutations known to raise the risk of additional cancers, according to a study published online April 12 in the Journal of Clinical Oncology.

Allison Kurian, M.D., an associate professor of medicine, health research, and policy at Stanford University in California, and colleagues note that treatment guidelines recommend that women with uncertain genetic results not be treated as aggressively as women who test positive for BRCA1/2.

The researchers found, however, that among the 666 breast cancer patients in the study who received genetic testing, women with uncertain genetic results were as likely as not to receive a double mastectomy. Only around half of breast cancer patients who underwent genetic testing discussed their results with a genetic counselor (57 percent at higher pretest risk, 42 percent at average risk). Only 7 to 10 percent of the women discussed their results with multiple health professionals on their treatment team (7 percent at high risk, 10 percent at average risk).

"Many patients with breast cancer are tested without ever seeing a genetic counselor. Half of average-risk patients with variants of uncertain significance undergo bilateral mastectomy, suggesting a limited understanding of results that some surgeons share," the authors write. "These findings emphasize the need to address challenges in personalized communication about genetic testing."

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Posted: April 2017