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

Veronica F. Quinn, Bettina Meiser, Judy Kirk, Kathy M. Tucker, Kaaren J. Watts, Belinda Rahman, Michelle Peate, Christobel Saunders, Elizabeth Geelhoed, Margaret Gleeson, Kristine Barlow-Stewart, Michael Field, Marion Harris, Yoland C. Antill, Linda Cicciarelli, Karen Crowe, Michael T. Bowen, Gillian Mitchell, P. Gregory, L. LiptonL. McKay, J. Senior, L. Lobb, P. Crowe, A. Matthews, G. Neil, A. Parasyn, D. Thomson, J. Duffy, L. Andrews, J. Gale, J. Fox, S. Hart, C. Smythe, M. White, L. Creighton, J. D'arcy, S. Grieve, E. Secomb, M. Henderson, J. O'Brien, C. Poliness, A. Hattam, R. Susman, O. Ung, R. DIckson, K. Moore, P. Bastick, S. Inder, J. Lynch, P. Schwartz, R. Zia, C. Mak, K. Snook, A. Spillane, J. Hopper, M. Bowman, D. Cheung, S. Edirimanne, E. Edwards, E. Elder, J. French, D. Moon

Research output: Contribution to journalArticle

15 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)448-456
Number of pages9
JournalGenetics in Medicine
Volume19
Issue number4
DOIs
Publication statusPublished - 1 Apr 2017

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