Talking to Your Doctor about Genetic Breast Cancer Risk

Genetic testing for breast cancer often not discussed with patients who wanted the procedure

(RxWiki News) Many women who are concerned about their family history of breast cancer may want to discuss genetic testing with their doctors. Many of these women, however, may not actually end up having this discussion.

A new study from the University of Michigan found that many women didn't have a discussion about genetic testing for breast cancer risk with their doctors. The authors of this study said this may highlight an unmet need.

Although these discussions can be complex and not all women are at risk, there is still a benefit to having these conversations, the authors of this study noted.

Reshma Jagsi, MD, DPhil, an associate professor of radiation oncology at the University of Michigan Medical School, led this study.

“Our findings suggest a marked unmet need for discussion about genetic risk," Dr. Jagsi said in a press release. "By addressing genetic risk with patients, we can better inform them of their true risk of cancer returning or of developing a new cancer. This could potentially alleviate worry and reduce confusion about cancer risk.”

Between 5 and 10 percent of women with breast cancer may have a raised risk of breast cancer because of an inherited genetic mutation, Dr. Jagsi and team noted. When a woman carries this mutation, her risk of developing a second breast cancer increases. Family members like sisters, mothers and daughters may also have an increased risk.

Adam M. Brufsky, MD, PhD, a board-certified doctor of internal medicine and medical oncology and associate director of clinical investigation for the University of Pittsburgh Cancer Institute, told dailyRx News that a discussion about genetic testing for breast cancer is a complex issue.

"Generally, this should likely be handled either by an Ob-Gyn, perhaps an internist, but more likely a high-risk breast clinic," Dr. Brufsky said.

Also, Dr. Brufsky said, "There should also be more public information disseminated on precise genetic risks of breast cancer in the general population."

Dr. Jagsi and colleagues surveyed 1,536 women who had been treated for breast cancer. They found that 35 percent of these women expressed a strong desire for genetic testing.

However, 43 percent of that group never had a discussion on the subject with a doctor. In women who spoke only Spanish, 85 percent wanted to talk about genetic testing.

Women who were younger and those with a family history of cancer were also more likely to want to have this discussion.

These women said they were worried about both their own risks and those of family members. Some women worried about breast cancer, while others worried about the risk of other types of cancers.

Although genetic testing can be very expensive depending on insurance coverage, Dr. Jagsi and team noted that the actual risk is low and misconceptions abound among breast cancer patients. This initial discussion can help to clarify these issues — whether or not a woman goes on for actual testing.

This study was published in April in the Journal of Clinical Oncology.

The National Cancer Institute and American Cancer Society funded this research. Conflict of interest disclosures were not available at the time of publication.

Review Date: 
April 6, 2015