|
1
|
Katz SJ, Ward KC, Hamilton AS, Abrahamse P, Hawley ST, Kurian AW. Association of Germline Genetic Test Type and Results With Patient Cancer Worry After Diagnosis of Breast Cancer. JCO Precis Oncol 2018; 2018:PO.18.00225. [PMID: 30656245 PMCID: PMC6333469 DOI: 10.1200/po.18.00225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND There are concerns that multigene panel testing compared with BRCA1/ 2-only testing after diagnosis of breast cancer may lead to unnecessary patient worry about cancer because of more ambiguous results. METHODS Patients with breast cancer diagnosed from 2013 to 2015 and accrued from SEER registries in Georgia and Los Angeles were surveyed (n = 5,080; response rate, 70%), and responses were merged with SEER data and germline genetic testing and results. We examined patient reports of cancer worry by test type and results in 1,063 women who linked to a genetic test and reported undergoing testing. RESULTS More than half of the sample (n = 640; 60.2%) received BRCA1/2-only testing versus 423 patients (39.8%) who had a multigene panel. A minority of tested patients reported substantial cancer worry after treatment: 11.1% (n = 130) reported higher impact of cancer worry, and 15.1% (n = 162) reported a high frequency of cancer worry (worrying often or almost always) in the past month. Impact of cancer worry did not substantively differ by test type, test result outcomes, or clinical or treatment factors. The odds ratio for higher impact of cancer worry was 0.81 (95% CI, 0.51 to 1.28) for multigene versus BRCA1/2-only testing. In a separate model, the odds ratios were 1.21 (95% CI, 0.54 to 2.68) and 0.90 (95% CI, 0.50 to 1.62) for pathogenic variant and variant of uncertain significance, respectively, versus a negative test (the reference group). CONCLUSION Compared with BRCA1/2 testing alone, multigene panel testing was not associated with increased cancer worry after diagnosis of breast cancer.
Collapse
Affiliation(s)
- Steven J. Katz
- Steven J. Katz, Paul Abrahamse, and Sarah T. Hawley, University of Michigan; Sarah T. Hawley, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI; Kevin C. Ward, Emory University, Atlanta, GA; Ann S. Hamilton, University of Southern California, Los Angeles; and Allison W. Kurian, Stanford University, Stanford, CA
| | - Kevin C. Ward
- Steven J. Katz, Paul Abrahamse, and Sarah T. Hawley, University of Michigan; Sarah T. Hawley, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI; Kevin C. Ward, Emory University, Atlanta, GA; Ann S. Hamilton, University of Southern California, Los Angeles; and Allison W. Kurian, Stanford University, Stanford, CA
| | - Ann S. Hamilton
- Steven J. Katz, Paul Abrahamse, and Sarah T. Hawley, University of Michigan; Sarah T. Hawley, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI; Kevin C. Ward, Emory University, Atlanta, GA; Ann S. Hamilton, University of Southern California, Los Angeles; and Allison W. Kurian, Stanford University, Stanford, CA
| | - Paul Abrahamse
- Steven J. Katz, Paul Abrahamse, and Sarah T. Hawley, University of Michigan; Sarah T. Hawley, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI; Kevin C. Ward, Emory University, Atlanta, GA; Ann S. Hamilton, University of Southern California, Los Angeles; and Allison W. Kurian, Stanford University, Stanford, CA
| | - Sarah T. Hawley
- Steven J. Katz, Paul Abrahamse, and Sarah T. Hawley, University of Michigan; Sarah T. Hawley, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI; Kevin C. Ward, Emory University, Atlanta, GA; Ann S. Hamilton, University of Southern California, Los Angeles; and Allison W. Kurian, Stanford University, Stanford, CA
| | - Allison W. Kurian
- Steven J. Katz, Paul Abrahamse, and Sarah T. Hawley, University of Michigan; Sarah T. Hawley, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI; Kevin C. Ward, Emory University, Atlanta, GA; Ann S. Hamilton, University of Southern California, Los Angeles; and Allison W. Kurian, Stanford University, Stanford, CA
| |
Collapse
|