Novel Approach Increases Breast, Ovarian Cancer Genetic Screening

Clinicians need reliable instruments to measure the functional consequences of treatments.
Clinicians need reliable instruments to measure the functional consequences of treatments.
A questionnaire added to intake forms at a breast cancer imaging center identified women with BRCA mutations who might otherwise have been missed.
The following article features coverage from the 2017 American Society of Clinical Oncology Annual Meeting in Chicago, Illinois. Click here to read more of Oncology Nurse Advisor‘s conference coverage.                        

CHICAGO — A simple tool for breast and ovarian cancer genetic screening of women when they visit a community breast imaging center is practical and can identify high-risk women who might otherwise be missed, researchers concluded in a study presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting.

Anne C. Kushwaha, MD, and colleagues at the MD Anderson Cancer Center in Houston, developed a questionnaire based on the Hereditary Breast and Ovarian Cancer (HBOC) genetic referral guidelines published by the National Comprehensive Cancer Network. They added the questionnaire to the intake forms of all patients seeking breast imaging at a breast imaging center based on the MD Anderson hospital. Radiologists reviewed the forms and flagged patients who met the guidelines of the tool.

Approximately 35,000 patients were seen during the study period (2012 to 2015). From this group, 1214 (3.5%) were flagged as possibly high risk. Of these, 189 patients had received prior genetic testing. Of the remaining 1025 patients identified as candidates for genetic counseling, 258 (25%) made a genetic counseling appointment and 163 (16%) received genetic counseling, Dr Kushwaha told attendees. Forty-one patients qualified for screening magnetic resonance imaging and 57 patients qualified for chemoprevention.

A total of 106 patients (65%) were tested for BRCA1 and BRCA2. Nine patients (8.5%) tested positive for BRCA1 or BRCA2 and 9 (7.5%) had a variant of unknown significance.

Dr Kushwaha concluded that the screening tool identified women with BRCA mutations who otherwise would have been missed by their primary care providers. Finding these patients has immediate implications for patients and their family members regarding surveillance and discussions about risk reductive surgery, she said.

“I recommend oncologists and other medical specialties to consider partnering with your local breast imaging centers to screen for these high-risk patients in their community,” Dr Kushwaha said.

Read more of Oncology Nurse Advisor‘s coverage of the 2017 American Society of Clinical Oncology Annual Meeting by visiting the conference page.

Reference

1. Kushwaha AC, Sweeney LE, Ghosh M, Arun B. High risk genetic screening program in a community hospital breast imaging center. Oral presentation at: 2017 American Society of Clinical Oncology Annual Meeting; June 2-6, 2017; Chicago, IL.