Breast cancer is the most common cancer diagnosed in women worldwide, with approximately 5–10% of cases attributed to high penetrance hereditary breast cancer (HBC) genes. The tremendous advances in precision oncology have broadened indications for germline genetic testing to guide both systemic and surgical treatment, with increasing demand for cancer genetic services. The HBC continuum of care includes (1) identification, access, and uptake of genetic counseling and testing; (2) the delivery of genetic counseling and testing services; and (3) initiation of guideline-adherent follow-up care and family communication of results. Challenges to delivering care on the HBC care continuum include factors such as access to services, cost, discrimination and bias, and lack of education and awareness, which can be mitigated through implementing a multi-level approach. This includes strategies such as increasing awareness and utilization of genetic counseling and testing, developing new methods to meet the growing demand for genetic services, and improving the uptake of follow-up care by increasing patient and provider awareness of the management recommendations.

Background. Over the past few years, next-generation tumor sequencing (NGS) panels have evolved in complexity and have changed from selected gene panels with a handful of genes to larger panels with hundreds of genes, sometimes in combination with paired germline filtering and/or testing. With this move toward increasingly large NGS panels, we have rapidly outgrown the available literature supporting the utility of treatments targeting many reported gene alterations making it challenging for oncology providers to interpret NGS results and make a therapy recommendation for their patients. Methods. To support the oncologists at Vanderbilt-Ingram Cancer Center (VICC) in interpreting NGS reports for patient care, we initiated two molecular tumor boards (MTBs)-a VICC-specific institutional board for our patients and a global community MTB open to the larger oncology patient

OBJECTIVES: The objectives of this workshop are to describe various types of linkable clinical and administrative claims data, review selected case studies, and highlight the strengths and limitations of these databases. PARTICIPANTS WHO WOULD BENEFIT: Those involved in planning, designing, implementing, and using data from retrospective database studies would benefit from this workshop. Administrative claims are increasingly used for outcomes research studies, despite known limitations associated with data reliability and validity, and a lack of clinical content. In recent years, efforts have been made to link claims to other sources, such as disease registries and clinical laboratory files, to create richer databases for research purposes. These linked data sources offer the potential for improved accuracy in case identification and outcomes ascertainment. For example, study patients can be selected based on their presence in a disease registry instead of relying on diagnoses reported on medical claim forms, and clinical laboratory files can be used to evaluate the success or failure of therapy. In this workshop, we will review, via case studies from oncology and diabetes, the content of linkable clinical and claims databases, the specific ways in which such data have been used in published outcomes studies, and the remaining limitations of this record linkage approach. Participants will learn how clinical data can be applied to strengthen studies of treatment costs and the burden of illness, and they will gain an appreciation of the improvements that linked data sources can make to the pharmacoeconomics and outcomes research fields. One case study will review applications of the SEER‐Medicare database, which includes a linkage between cancer registry data and Medicare administrative claims for approximately 14% of U.S. cancer cases across 17 diverse regions. The other illustration will describe published studies of the economic benefits of improving glycemic control among diabetes patients, in which claims data from several managed‐care organizations were linked to glycosylated hemoglobin test results.

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