TY - JOUR
T1 - Streamlined genetic education is effective in preparing women newly diagnosed with breast cancer for decision making about treatment-focused genetic testing
T2 - a randomized controlled noninferiority trial
AU - Quinn, Veronica F.
AU - Meiser, Bettina
AU - Kirk, Judy
AU - Tucker, Kathy M.
AU - Watts, Kaaren J.
AU - Rahman, Belinda
AU - Peate, Michelle
AU - Saunders, Christobel
AU - Geelhoed, Elizabeth
AU - Gleeson, Margaret
AU - Barlow-Stewart, Kristine
AU - Field, Michael
AU - Harris, Marion
AU - Antill, Yoland C.
AU - Cicciarelli, Linda
AU - Crowe, Karen
AU - Bowen, Michael T.
AU - Mitchell, Gillian
AU - The TFGT Collaborative Group
AU - Gregory, P.
AU - Lipton, L.
AU - McKay, L.
AU - Senior, J.
AU - Lobb, L.
AU - Crowe, P.
AU - Matthews, A.
AU - Neil, G.
AU - Parasyn, A.
AU - Thomson, D.
AU - Duffy, J.
AU - Andrews, L.
AU - Gale, J.
AU - Fox, J.
AU - Hart, S.
AU - Smythe, C.
AU - White, M.
AU - Creighton, L.
AU - D'arcy, J.
AU - Grieve, S.
AU - Secomb, E.
AU - Henderson, M.
AU - O'Brien, J.
AU - Poliness, C.
AU - Hattam, A.
AU - Susman, R.
AU - Ung, O.
AU - Dickson, R.
AU - Moore, K.
AU - Bastick, P.
AU - Inder, S.
AU - Lynch, J.
AU - Schwartz, P.
AU - Zia, R.
AU - Mak, C.
AU - Snook, K.
AU - Spillane, A.
AU - Hopper, J.
AU - Bowman, M.
AU - Cheung, D.
AU - Edirimanne, S.
AU - Edwards, E.
AU - Elder, E.
AU - French, J.
AU - Moon, D.
PY - 2017/4
Y1 - 2017/4
N2 - Purpose: Increasingly, women newly diagnosed with breast cancer are being offered treatment-focused genetic testing (TFGT). As the demand for TFGT increases, streamlined methods of genetic education are needed. Methods: In this noninferiority trial, women aged <50 years with either a strong family history (FH+) or other features suggestive of a germ-line mutation (FH-) were randomized before definitive breast cancer surgery to receive TFGT education either as brief written materials (intervention group (IG)) or during a genetic counseling session at a familial cancer clinic (usual-care group (UCG)). Women completed self-report questionnaires at four time points over 12 months. Results: A total of 135 women were included in the analysis, all of whom opted for TFGT. Decisional conflict about TFGT choice (primary outcome) was not inferior in the IG compared with the UCG (noninferiority margin of -10; mean difference = 2.45; 95% confidence interval -2.87-7.76; P = 0.36). Costs per woman counseled in the IG were significantly lower (AUD$89) compared with the UCG (AUD$173; t(115) = 6.02; P < 0.001). Conclusion: A streamlined model of educating women newly diagnosed with breast cancer about TFGT seems to be a cost-effective way of delivering education while ensuring that women feel informed and supported in their decision making, thus freeing resources for other women to access TFGT.
AB - Purpose: Increasingly, women newly diagnosed with breast cancer are being offered treatment-focused genetic testing (TFGT). As the demand for TFGT increases, streamlined methods of genetic education are needed. Methods: In this noninferiority trial, women aged <50 years with either a strong family history (FH+) or other features suggestive of a germ-line mutation (FH-) were randomized before definitive breast cancer surgery to receive TFGT education either as brief written materials (intervention group (IG)) or during a genetic counseling session at a familial cancer clinic (usual-care group (UCG)). Women completed self-report questionnaires at four time points over 12 months. Results: A total of 135 women were included in the analysis, all of whom opted for TFGT. Decisional conflict about TFGT choice (primary outcome) was not inferior in the IG compared with the UCG (noninferiority margin of -10; mean difference = 2.45; 95% confidence interval -2.87-7.76; P = 0.36). Costs per woman counseled in the IG were significantly lower (AUD$89) compared with the UCG (AUD$173; t(115) = 6.02; P < 0.001). Conclusion: A streamlined model of educating women newly diagnosed with breast cancer about TFGT seems to be a cost-effective way of delivering education while ensuring that women feel informed and supported in their decision making, thus freeing resources for other women to access TFGT.
KW - BRCA1
KW - BRCA2
KW - genetic counseling
KW - psychological adjustment
KW - rapid testing
UR - https://www.scopus.com/pages/publications/85017147488
U2 - 10.1038/gim.2016.130
DO - 10.1038/gim.2016.130
M3 - Article
C2 - 27684037
AN - SCOPUS:85017147488
SN - 1098-3600
VL - 19
SP - 448
EP - 456
JO - Genetics in Medicine
JF - Genetics in Medicine
IS - 4
ER -