Barriers to genetic testing in newly diagnosed breast cancer patients: Do surgeons limit testing?

- Genetic counseling of newly diagnosed breast cancer patients is not uniformly performed.
- The largest barrier to genetic testing we identified was lack of physician referral.
- We should improve provider education and discuss testing implications with patients.
- Counseling appointments need to be convenient.
- We should provide resources regarding financial information and other FAQ's.

BackgroundGenetic testing results influence treatment recommendations in newly diagnosed breast cancer patients. However, at-risk patients do not uniformly undergo genetic testing. The goal of this study was to identify barriers to genetic testing in newly diagnosed breast cancer patients.MethodsA prospective database of newly diagnosed breast cancer patients meeting specific criteria over an 18-month period was created and retrospectively reviewed.ResultsA total of 532 patients were identified at risk for genetic mutation. Of these 313 (59%) patients completed a genetic counseling appointment and 292 (55%) underwent genetic testing. One hundred seven (24%) were never referred to genetic counselors and 89 (17%) were referred but did not complete an appointment. Patients referred to genetics were younger than the nonreferred patients (50.9 vs 60.6 years, P < .001). The 89 women referred to genetics who did not complete an appointment were surveyed and had varied reasons for not completing an appointment.ConclusionsThe largest barrier to genetic testing was lack of physician referral; therefore, provider education must be improved. Appointments should be convenient and providers should proactively discuss the significant implications of testing results.