A pilot study investigating feasibility of mainstreaming germline BRCA1 and BRCA2 testing in high-risk patients with breast and/or ovarian cancer in three tertiary Cancer Centres in Ireland

McVeigh, Terri P; Sweeney, Karl; Brennan, Donal J.; McVeigh, Una Mary; Ward, Simon V.; Strydom, Ann; Seal, Sheila; Astbury, Katherine; Donnellan, Paul; Higgins, Joanne; Keane, Maccon M.; Kerin, Michael J.; Malone, Carmel; McGough, Pauline; McLaughlin, Ray; O’Leary, Michael J.; Rushe, Margaret; Barry, Michael Kevin; MacGregor, Geraldine; Sugrue, Michael; Yousif, Ala; Al-Azawi, Dhafir; Berkeley, Eileen; Boyle, Terence J.; Connolly, Elizabeth; Nolan, Carmel; Richardson, Elaine; Giffney, Claire; Doyle, S.B.; Broderick, Sheila; Boyd, William M.; McVey, Ruaidhrí; Walsh, Thomas A.; Farrell, Michael; Gallagher, David J.; Rahman, Nazneen; George, Angela

doi:10.1007/s10689-022-00313-0

Cited by 4 publications

(4 citation statements)

References 69 publications

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“…On the other hand, in our breast cancer mainstreaming pathway, the majority of participating healthcare professionals consisted of nurses and nurse specialists (Chapter 6). This is in contrast to the majority of previous studies about mainstreaming for breast cancer, in which healthcare professionals involved consisted predominantly of doctors (29,33,39,41,44,(47)(48)(49)(50). These previous studies also showed a large role for medical oncologists (29,39,47,48,50).…”

contrasting

confidence: 57%

“…Pre-test counseling includes reviewing and confirming family history, determining whether the patient is eligible for genetic testing, obtaining informed consent and ordering the genetic test if the patient is eligible and accepts the genetic test. Typically, this takes about 40 to 50 minutes per patient (39)(40)(41). Test results are disclosed by the genetic counselor by telephone, in-person or via video conference (42).…”

Section: (4) Impact On Choices and Planning Regarding Reproductionmentioning

confidence: 99%

“…Several modules have been developed to train healthcare professionals in how to provide counseling regarding hereditary diseases (40,41). Many of these have been developed for NGHCPs and they mainly focus on attitudes about counseling, communication skills and knowledge.…”

Section: Quality Of Carementioning

confidence: 99%

“…For ovarian cancer, the majority of participating healthcare professionals consisted of doctors and almost all invited gynecologic oncologists and gynecologists with a subspecialty training in oncology were actively involved in the pathway (Chapter 3). In previous mainstreaming studies for ovarian cancer, participating healthcare professionals also consisted for the majority or only of doctors (26,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46). On the other hand, in our breast cancer mainstreaming pathway, the majority of participating healthcare professionals consisted of nurses and nurse specialists (Chapter 6).…”

mentioning

confidence: 99%

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Integrating germline genetic testing into routine care of patients with breast or ovarian cancer

Bokkers¹

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It is important to identify patients with breast or ovarian cancer who carry a hereditary predisposition for cancer. Identifying such a hereditary predisposition may impact treatment and surveillance options to prevent or identify a second cancer in an early stage. In addition, family members may also be eligible for surveillance options if they carry the same hereditary predisposition. Despite these important implications, not all patients with breast or ovarian cancer who are eligible for genetic testing are referred to a genetics department for counseling and testing. Therefore, we aimed to make genetic testing more accessible to patients with breast or ovarian cancer. This thesis describes the development, implementation and evaluation of mainstream genetic testing. In these mainstream genetic testing pathways, non-genetic healthcare professionals (i.e., doctors and nurses who are already treating the patient) discuss the advantages and disadvantages of genetic testing and order genetic testing themselves for their patients after completing a concise online training. The results show that non-genetic healthcare professionals in both breast and ovarian cancer care have predominantly positive attitudes toward mainstream genetic testing and it is feasible for them to incorporate genetic testing into their routine care. Patients feel well-informed after counseling about genetic testing and mainstream genetic testing provides good quality of care. For patients with ovarian cancer, mainstream genetic testing led to higher testing rates and a reduction in genetics-related healthcare costs. Based on these results, we can conclude that mainstream genetic testing for patients with breast or ovarian cancer is acceptable and feasible for both healthcare professionals and patients to incorporate into routine care.

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contrasting

confidence: 57%

Section: (4) Impact On Choices and Planning Regarding Reproductionmentioning

confidence: 99%

Section: Quality Of Carementioning

confidence: 99%

mentioning

confidence: 99%

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Integrating germline genetic testing into routine care of patients with breast or ovarian cancer

Bokkers¹

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Postgraduate training in Cancer Genetics—a cross-specialty survey exploring experience of clinicians in Ireland

et al. 2021

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Background As genomic profiling of constitutional and tumour-derived DNA becomes increasingly critical in cancer risk estimation, prognostication and treatment, there is a growing need for clinicians involved in cancer care to up-skill in Cancer Genetics. In the Republic of Ireland (ROI), this is particularly crucial, given a paucity of vocationally trained Clinical Geneticists per capita compared to other European countries. Aims We aimed to assess the self-reported confidence of postgraduate medical/surgical trainees in ROI in requesting, interpreting, and managing genomic data in patients with cancer, and to assess their selfreported experience, and demand for future training in this area. Methods A cross-sectional survey of postgraduate trainees in four specialties (Medical and Radiation Oncology, Surgery, and Obstetrics and Gynaecology (O&G)), training in ROI, was undertaken. A bespoke electronic questionnaire was designed to capture data regarding preceding experience, and confidence across several hypothetical clinical scenarios involving genomic testing. The survey was circulated to eligible participants by training programme administrators, after relevant institutional ethical approval. Data was collected anonymously. Results The study cohort included 62 respondents. A paucity of cancer genetics training at every level was demonstrated, with “hardly any” or “none at all” reported by 47(76%), 62(100%), and 50(81%) during undergraduate, core specialty, and higher specialist training, respectively. A relative lack of confidence in all clinical scenarios was apparent, particularly among Surgery/O&G trainees. Most respondents would value more training in Cancer Genetics. Conclusions This study demonstrates an unmet need in dedicated Cancer Genetics training for postgraduate specialty trainees in ROI.

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Patients’ experiences with pre-test genetic counseling provided by breast cancer healthcare professionals: Results from a large prospective multicenter study

Bokkers¹,

Bleiker²,

Velthuizen³

et al. 2023

The Breast

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A pilot study investigating feasibility of mainstreaming germline BRCA1 and BRCA2 testing in high-risk patients with breast and/or ovarian cancer in three tertiary Cancer Centres in Ireland

Cited by 4 publications

References 69 publications

Integrating germline genetic testing into routine care of patients with breast or ovarian cancer

Integrating germline genetic testing into routine care of patients with breast or ovarian cancer

Postgraduate training in Cancer Genetics—a cross-specialty survey exploring experience of clinicians in Ireland

Patients’ experiences with pre-test genetic counseling provided by breast cancer healthcare professionals: Results from a large prospective multicenter study

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