1. Patient feedback and early outcome data with a novel tiered-binned model for multiplex breast cancer susceptibility testing
- Author
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Susan M. Domchek, Kara N. Maxwell, Brian L. Egleston, Angela R. Bradbury, Tyler Chavez, Jessica M. Long, Jacquelyn Powers, Evelyn Stevens, Jamie Brower, Katherine L. Nathanson, Diana Harris, Laura DiGiovanni, Jill Stopfer, Linda Patrick-Miller, Amanda Brandt, and Abha Kulkarni
- Subjects
Counseling ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Susceptibility testing ,Genetic counseling ,Decision Making ,education ,Breast Neoplasms ,Genetic Counseling ,030105 genetics & heredity ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,health services administration ,Internal medicine ,medicine ,Humans ,Genetic Predisposition to Disease ,natural sciences ,Multiplex ,Genetic Testing ,Hardware_ARITHMETICANDLOGICSTRUCTURES ,Early Detection of Cancer ,health care economics and organizations ,Genetics (clinical) ,BRCA2 Protein ,Informed Consent ,BRCA1 Protein ,business.industry ,Uncertainty ,food and beverages ,Middle Aged ,medicine.disease ,Surgery ,Patient feedback ,ComputingMethodologies_PATTERNRECOGNITION ,030220 oncology & carcinogenesis ,Female ,Outcome data ,business - Abstract
The risks, benefits, and utilities of multiplex panels for breast cancer susceptibility are unknown, and new counseling and informed consent models are needed. We sought to obtain patient feedback and early outcome data with a novel tiered-binned model for multiplex testing.BRCA1/2-negative and untested patients completed pre- and posttest counseling and surveys evaluating testing experiences and cognitive and affective responses to multiplex testing.Of 73 patients, 49 (67%) completed pretest counseling. BRCA1/2-negative patients were more likely to proceed with multiplex testing (86%) than those untested for BRCA1/2 (43%; P0.01). Many patients declining testing reported concern for uncertainty and distress. Most patients would not change anything about their pre- (76%) or posttest (89%) counseling sessions. Thirty-three patients (72%) were classified as making an informed choice, including 81% of those who proceeded with multiplex testing. Knowledge increased significantly. Anxiety, depression, uncertainty, and cancer worry did not significantly increase with multiplex testing.Some patients, particularly those without prior BRCA1/2 testing, decline multiplex testing. Most patients who proceeded with testing did not experience negative psychological responses, but larger studies are needed. The tiered-binned approach is an innovative genetic counseling and informed consent model for further study in the era of multiplex testing.Genet Med 18 1, 25-33.
- Published
- 2016
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