Mechanisms to increase cascade testing in hereditary breast and ovarian cancer: Impact of introducing standardized communication aids into genetic counseling - PubMed

Mechanisms to increase cascade testing in hereditary breast and ovarian cancer: Impact of introducing standardized communication aids into genetic counseling - PubMed

Mechanisms to increase cascade testing in hereditary breast and ovarian cancer: Impact of introducing standardized communication aids into genetic counseling

Christine Garcia 1 2, Mackenzie W Sullivan 3, Heather Lothamer 1, Kara M Harrison 3, Lindsay Chatfield 3, Martha H Thomas 4, Susan C Modesitt 1

Affiliations 

• PMID: 32656916
 
• DOI: 10.1111/jog.14366

Abstract

Aim: Precancer identification of women with hereditary breast and ovarian cancer (HBOC) could prevent 20% of these ovarian cancers. The objective was to determine whether standardized Facing Our Risk of Cancer Empowered (FORCE) materials are acceptable, improve knowledge of HBOC and increase disclosure to family members.

Methods: A prospective cohort of women with breast or ovarian cancer was identified prior to genetic testing. Subjects completed a baseline knowledge survey and were provided three communication aids. Knowledge, acceptability and communication to family members were reassessed at 6 months and compared to a retrospective cohort who had undergone genetic testing for breast or ovarian cancer prior to the intervention. The primary outcome was increase in HBOC knowledge, requiring 20 pre- and postknowledge scores to detect a 10% difference.

Results: Forty women were enrolled. The median age at cancer diagnosis was 50 years and 55% had a family history of breast or ovarian cancer. Though subjects found the resources acceptable, knowledge scores did not improve after their use. Disclosure rates were of no different between cohorts (83% preintervention vs 77% postintervention, P = 0.26) though there was an increase in deleterious mutation carriers, 0% (0/6) preintervention vs 100% (22/22) postintervention. Rates of subsequent testing in relatives were low in both preintervention and postintervention cohorts (0% vs 4.5%).

Conclusion: Inclusion of standardized communication tools is acceptable to patients. Knowledge did not improve after their use. In deleterious mutation carriers, disclosure rates increased postintervention.

Keywords: BRCA; breast cancer; cascade testing; genetic testing; ovarian cancer.

© 2020 Japan Society of Obstetrics and Gynecology.

Similar articles

• Cancer Predisposition Cascade Screening for Hereditary Breast/Ovarian Cancer and Lynch Syndromes in Switzerland: Study Protocol.

  Katapodi MC, Viassolo V, Caiata-Zufferey M, Nikolaidis C, Bührer-Landolt R, Buerki N, Graffeo R, Horváth HC, Kurzeder C, Rabaglio M, Scharfe M, Urech C, Erlanger TE, Probst-Hensch N, Heinimann K, Heinzelmann-Schwarz V, Pagani O, Chappuis PO.JMIR Res Protoc. 2017 Sep 20;6(9):e184. doi: 10.2196/resprot.8138.PMID: 28931501 Free PMC article.
• Prophylactic Oophorectomy: Reducing the U.S. Death Rate from Epithelial Ovarian Cancer. A Continuing Debate.

  Piver MS.Oncologist. 1996;1(5):326-330.PMID: 10388011
• Awareness and attitude regarding reproductive options of persons carrying a BRCA mutation and their partners.

  Gietel-Habets JJ, de Die-Smulders CE, Derks-Smeets IA, Tibben A, Tjan-Heijnen VC, van Golde R, Gomez-Garcia E, Kets CM, van Osch LA.Hum Reprod. 2017 Mar 1;32(3):588-597. doi: 10.1093/humrep/dew352.PMID: 28073972
• BRCA1- and BRCA2-Associated Hereditary Breast and Ovarian Cancer.

  Petrucelli N, Daly MB, Pal T.1998 Sep 4 [updated 2016 Dec 15]. In: Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Stephens K, Amemiya A, editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993–2020.PMID: 20301425 Free Books & Documents. Review.
• Genetic Risk Assessment and BRCA Mutation Testing for Breast and Ovarian Cancer Susceptibility [Internet].

  Nelson HD, Huffman LH, Fu R, Harris EL, Walker M, Bougatsos C.Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Sep.PMID: 20722133 Free Books & Documents. Review.