Steven J Katz1, Kevin C Ward2, Ann S Hamilton3, Paul Abrahamse1, Sarah T Hawley4, Allison W Kurian5. 1. University of Michigan. 2. Emory University, Atlanta, GA. 3. University of Southern California, Los Angeles. 4. University of Michigan, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI. 5. Stanford University, Stanford, CA.
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.
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.
Authors: Allison W Kurian; Irina Bondarenko; Reshma Jagsi; Christopher R Friese; M Chandler McLeod; Sarah T Hawley; Ann S Hamilton; Kevin C Ward; Timothy P Hofer; Steven J Katz Journal: J Natl Cancer Inst Date: 2018-05-01 Impact factor: 13.506
Authors: Allison W Kurian; Kevin C Ward; Ann S Hamilton; Dennis M Deapen; Paul Abrahamse; Irina Bondarenko; Yun Li; Sarah T Hawley; Monica Morrow; Reshma Jagsi; Steven J Katz Journal: JAMA Oncol Date: 2018-08-01 Impact factor: 31.777
Authors: Sarah T Hawley; Nancy K Janz; Kent A Griffith; Reshma Jagsi; Christopher R Friese; Allison W Kurian; Ann S Hamilton; Kevin C Ward; Monica Morrow; Lauren P Wallner; Steven J Katz Journal: Breast Cancer Res Treat Date: 2016-12-21 Impact factor: 4.624
Authors: Allison W Kurian; Kent A Griffith; Ann S Hamilton; Kevin C Ward; Monica Morrow; Steven J Katz; Reshma Jagsi Journal: JAMA Date: 2017-02-07 Impact factor: 157.335
Authors: Allison W Kurian; Yun Li; Ann S Hamilton; Kevin C Ward; Sarah T Hawley; Monica Morrow; M Chandler McLeod; Reshma Jagsi; Steven J Katz Journal: J Clin Oncol Date: 2017-04-12 Impact factor: 50.717
Authors: Steven J Katz; Kevin C Ward; Ann S Hamilton; M Chandler Mcleod; Lauren P Wallner; Monica Morrow; Reshma Jagsi; Sarah T Hawley; Allison W Kurian Journal: J Clin Oncol Date: 2018-03-12 Impact factor: 50.717
Authors: Nancy K Janz; Yun Li; Brian J Zikmund-Fisher; Reshma Jagsi; Allison W Kurian; Lawrence C An; M Chandler McLeod; Kamaria L Lee; Steven J Katz; Sarah T Hawley Journal: Breast Cancer Res Treat Date: 2016-12-09 Impact factor: 4.624
Authors: Kristin Clift; Sarah Macklin; Colin Halverson; Jennifer B McCormick; Abd Moain Abu Dabrh; Stephanie Hines Journal: J Community Genet Date: 2019-08-20
Authors: Allison W Kurian; Kevin C Ward; Paul Abrahamse; Irina Bondarenko; Ann S Hamilton; Dennis Deapen; Monica Morrow; Jonathan S Berek; Timothy P Hofer; Steven J Katz Journal: J Clin Oncol Date: 2021-02-09 Impact factor: 44.544
Authors: Julie O Culver; Charité N Ricker; Joseph Bonner; John Kidd; Duveen Sturgeon; Rachel Hodan; Kerry Kingham; Katrina Lowstuter; Nicolette M Chun; Alexandra P Lebensohn; Courtney Rowe-Teeter; Peter Levonian; Katlyn Partynski; Karlena Lara-Otero; Christine Hong; Jennifer Morales Pichardo; Meredith A Mills; Krystal Brown; Caryn Lerman; Uri Ladabaum; Kevin J McDonnell; James M Ford; Stephen B Gruber; Allison W Kurian; Gregory E Idos Journal: Cancer Date: 2020-12-15 Impact factor: 6.921