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Patients with pathogenic variants for breast cancer other than BRCA1 and BRCA2: qualitative interviews about health care experiences

Patients with pathogenic variants for breast cancer other than BRCA1 and BRCA2: qualitative interviews about health care experiences

Authors :
Clift, Kristin E.
Macklin, Sarah K.
Hines, Stephanie L.
Source :
Hereditary Cancer in Clinical Practice. December 16, 2019, Vol. 17 Issue 1
Publication Year :
2019

Abstract

Background Genetic testing for hereditary cancer syndromes has been revolutionized by next-generation sequencing, which allows for simultaneous review of numerous genes. Multigene panels are regularly offered to patients because of their scope and decreased cost and turnaround time. However, many genes included on larger panels have not been studied as extensively as BRCA1 and BRCA2 (BRCA1/2), and their clinical effects are often not as well established. Methods We identified patients who received positive test results for pathogenic variants of breast cancer genes from January 2012 through May 2018. We mailed a survey and conducted qualitative interviews to explore the personal and health care experiences of patients with pathogenic variants of BRCA1/2 and patients with 'other' (ie, non-BRCA1/2 or PALB2; PTEN; ATM; TP53; NBM, RAD51C; MSH6) variants. We compared the experiences of these patients. Results Fifty-nine out of 128 individuals responded to the survey (46%). Thirty-two patients had BRCA1/2 variants, and 27 had other variants. (49 women and 10 men; median [range] age, 63 [34-87] years). We interviewed 21 patients (17 women and 4 men; median [range] age, 59.6 [34-82] years). Of the interview participants, ten patients had BRCA1/2 variants, and 11 had non-BRCA1/2 variants. Patients reported receiving poor information about their genetic test results, and they often educated their physicians about their results. Some patients believed that they had been ignored or 'brushed off' by health care professionals because non-BRCA1/2 genes are less understood outside the genetics research community. Patients with BRCA1/2 variants had similar problems with health care providers, despite increased awareness and established guidelines about BRCA1/2. Conclusions Research is required to understand the clinical significance and proper management of diseases attributable to newly characterized hereditary cancer genes. Additional evaluation of patient and provider education should be at the forefront of efforts to improve patient care. Keywords: Familial cancer, Genetic counseling, Genetic risk, Genetics, Hereditary breast cancer, Qualitative research, PALB2, PTEN, ATM, TP53, NBM, RAD51C, MSH6<br />Author(s): Kristin E. Clift[sup.1], Sarah K. Macklin[sup.2] and Stephanie L. Hines[sup.3] Background Since the 1990s, genetic testing has been offered to patients at high risk for pathogenic variants of the [...]

Details

Language :
English
ISSN :
17312302
Volume :
17
Issue :
1
Database :
Gale General OneFile
Journal :
Hereditary Cancer in Clinical Practice
Publication Type :
Academic Journal
Accession number :
edsgcl.610311564
Full Text :
https://doi.org/10.1186/s13053-019-0132-6