Surgeons Make the Call on Gene Tests for Breast Cancer Patients
TUESDAY, July 3, 2018 -- When it comes to genetic testing for breast cancer patients, their surgeons wield great influence on that decision, new research shows.
Genetic testing can provide important information that might affect treatment choices for breast cancer, but previous research shows that only about half of women who could benefit received such testing.
This new study found that surgeons have a significant influence on genetic testing among breast cancer patients.
The study included 3,910 women with early stage breast cancer and the 370 surgeons who treated them. Twenty-seven percent of the patients received genetic testing, including 52 percent of those with a higher risk of a genetic mutation.
Genetic testing is recommended for breast cancer patients with an elevated risk of a genetic mutation based on age, family history of cancer or characteristics of their cancer.
Several factors played a role in the variability of genetic testing, the study found. An elevated risk of a genetic mutation accounted for 20 percent of that variability, but a woman's surgeon accounted for 17 percent.
Among women who met the recommended guidelines for genetic testing, rates ranged from 26 percent to 72 percent based on surgeon. Those surgeons who saw more breast cancer patients were more likely to recommend testing, the researchers found.
There was wide variation in surgeons' confidence in talking about the pros and cons of genetic testing, suggesting the need for better guidelines and training, according to the study authors.
"The surge of genetic testing in cancer care is a major challenge for surgeons," said lead author Dr. Steven Katz. He's professor of general medicine and of health management and policy at the University of Michigan.
"There is a lack of consensus around guidelines and approach to testing, and legitimate uncertainty about its value in guiding treatment, especially with newer genes whose cancer risks are not well-defined," Katz said in a university news release.
"Genetic testing can help inform decisions about breast cancer treatment and prevention of future cancers in patients and in their families. It's important to ensure patients who need this information receive it as part of the treatment discussion, regardless of the surgeon they see," he concluded.
The study was published in the journal JAMA Surgery.
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Posted: July 2018