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 Of an estimated 3.8 million women in the U.S. with a history of
breast or ovarian malignancies, up to 15 percent might have
inherited genetic mutations that could help determine the best
approach to their care, researchers note in the Journal of Clinical
Oncology.
For the study, researchers focused on women who were considered
eligible for genetic testing by current guidelines. All women with
ovarian cancer are eligible. With breast cancer, eligibility depends
on women’s age at diagnosis as well as the age at diagnosis for any
close relatives with breast tumors.
Among women diagnosed with breast cancer, about 36 percent were
eligible for genetic testing but just 15 percent got tested, the
study found. Only 11 percent of women with ovarian cancer got
tested.
“Over a million women with breast or ovarian cancer who should get
getting genetic testing have not,” said lead study author Dr.
Christopher Childers of the University of California, Los Angeles.
“Perhaps more shocking was that over 75 percent of these women have
never even discussed the possibility of genetic testing with a
healthcare provider,” Childers told Reuters Health by email.
Women with certain gene mutations may have especially aggressive
tumors that grow rapidly and spread quickly. Genetic tests can
identify which women may benefit from a newer generation of targeted
cancer therapies that attack tumors caused by specific gene
mutations, most of which are inherited.
Results may also help a woman decide what type of surgery to have
based on her risk for recurrent cancer or new cancers, and can also
guide testing for daughters or other close female family members.
For the study, researchers examined survey responses from a
nationally representative sample of U.S. adults, including 47,218
women with complete information on whether they had discussed
genetic testing with their doctors, were told to get tests and
actually received tests.
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Among these women, about 2.7 percent had been diagnosed with breast
cancer and 0.4 percent had been diagnosed with ovarian tumors.
About 29 percent of the women with breast cancer who were eligible
for testing discussed it with healthcare providers, and 20 percent
were told to get tests.
Women with breast cancer were a little more likely to get needed
tests when they were 45 or younger at the time of their diagnosis
than those who were older.
Only about 15 percent of women with ovarian cancer who were eligible
for genetic testing discussed it with providers, and just 13 percent
were advised to get tests.
One limitation of the study is that it relied on survey data,
requiring women to accurately recall and report on conversations
about genetic testing that might have happened many years ago, the
authors note.
But the results still highlight a need to get more patients tested,
said Dr. Kevin Hughes of Massachusetts General Hospital and Harvard
Medical School in Boston.
“If the woman or any member of her family had ovarian cancer, if
there are more than 3 breast cancers in her family, if a male has
had breast cancer, testing is always needed,” Hughes, author of an
accompanying editorial, said by email.
“But even lesser family histories can prompt testing,” Hughes added.
“We have entered an era where testing is inexpensive and its
benefits are obvious, and therefore we have lowered the threshold as
to who can be tested.”
SOURCE: http://bit.ly/2gLA1ea and http://bit.ly/2xeitSD Journal of
Clinical Oncology, online August 18, 2017.
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