Streamlined genetic education is effective in preparing women newly diagnosed with breast cancer for decision making about treatment-focused genetic testing: a randomized controlled noninferiority trial.

Quinn VF1, Meiser B1, Kirk J2,3, Tucker KM4, Watts KJ1, Rahman B1, Peate M1,5, Saunders C6, Geelhoed E7, Gleeson M8, Barlow-Stewart K9, Field M10,Harris M11, Antill YC11,12, Cicciarelli L13, Crowe K14, Bowen MT15, Mitchell G13,16.

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Abstract

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.Genet Med advance online publication 29 September 2016Genetics in Medicine (2016); doi:10.1038/gim.2016.130.