Lucie G Hallenstein1,2, Carol Sorensen3, Lorraine Hodgson4, Shelly Wen2, Justin Westhuyzen2, Carmen Hansen5, Andrew T J Last5, Julan V Amalaseelan6, Shehnarz Salindera7, William Ross7,8, Allan D Spigelman9, Thomas P Shakespeare2,8, Noel J Aherne10,11,12. 1. Cancer Genetics Service, Mid North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia. 2. Department of Radiation Oncology, Mid North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia. 3. Cancer Genetics Service, Mid North Coast Cancer Institute, Port Macquarie, New South Wales, Australia. 4. Kingscliff Community Health, Kingscliff, New South Wales, Australia. 5. Department of Radiation Oncology, Mid North Coast Cancer Institute, Port Macquarie, New South Wales, Australia. 6. Department of Radiation Oncology, North Coast Cancer Institute, Lismore, New South Wales, Australia. 7. Department of Surgery, University of New South Wales, St Vincent's Clinical School, Sydney, New South Wales, Australia. 8. Rural Clinical School Faculty of Medicine, University of New South Wales, St Vincent's Clinical School, Sydney, New South Wales, Australia. 9. Cancer Genetics Unit, The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, New South Wales, Australia. 10. Department of Radiation Oncology, Mid North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia. noel.aherne@health.nsw.gov.au. 11. Rural Clinical School Faculty of Medicine, University of New South Wales, St Vincent's Clinical School, Sydney, New South Wales, Australia. noel.aherne@health.nsw.gov.au. 12. School of Health and Human Sciences, Southern Cross University, Coffs Harbour, New South Wales, Australia. noel.aherne@health.nsw.gov.au.
Abstract
BACKGROUND: Guidelines for referral to cancer genetics service for women diagnosed with triple negative breast cancer have changed over time. This study was conducted to assess the changing referral patterns and outcomes for women diagnosed with triple negative breast cancer across three regional cancer centres during the years 2014-2018. METHODS: Following ethical approval, a retrospective electronic medical record review was performed to identify those women diagnosed with triple negative breast cancer, and whether they were referred to a genetics service and if so, the outcome of that genetics assessment and/or genetic testing. RESULTS: There were 2441 women with newly diagnosed breast cancer seen at our cancer services during the years 2014-2018, of whom 237 women were diagnosed with triple negative breast cancer. Based on age of diagnosis criteria alone, 13% (31/237) of our cohort fulfilled criteria for genetic testing, with 81% (25/31) being referred to a cancer genetics service. Of this group 68% (21/31) were referred to genetics services within our regions and went on to have genetic testing with 10 pathogenic variants identified; 5x BRCA1, 4x BRCA2 and × 1 ATM:c.7271 T > G. CONCLUSIONS: Referral pathways for women diagnosed with TNBC to cancer genetics services are performing well across our cancer centres. We identified a group of women who did not meet eligibility criteria for referral at their time of diagnosis, but would now be eligible, as guidelines have changed. The use of cross-discipline retrospective data reviews is a useful tool to identify patients who could benefit from being re-contacted over time for an updated cancer genetics assessment.
BACKGROUND: Guidelines for referral to cancer genetics service for women diagnosed with triple negative breast cancer have changed over time. This study was conducted to assess the changing referral patterns and outcomes for women diagnosed with triple negative breast cancer across three regional cancer centres during the years 2014-2018. METHODS: Following ethical approval, a retrospective electronic medical record review was performed to identify those women diagnosed with triple negative breast cancer, and whether they were referred to a genetics service and if so, the outcome of that genetics assessment and/or genetic testing. RESULTS: There were 2441 women with newly diagnosed breast cancer seen at our cancer services during the years 2014-2018, of whom 237 women were diagnosed with triple negative breast cancer. Based on age of diagnosis criteria alone, 13% (31/237) of our cohort fulfilled criteria for genetic testing, with 81% (25/31) being referred to a cancer genetics service. Of this group 68% (21/31) were referred to genetics services within our regions and went on to have genetic testing with 10 pathogenic variants identified; 5x BRCA1, 4x BRCA2 and × 1 ATM:c.7271 T > G. CONCLUSIONS: Referral pathways for women diagnosed with TNBC to cancer genetics services are performing well across our cancer centres. We identified a group of women who did not meet eligibility criteria for referral at their time of diagnosis, but would now be eligible, as guidelines have changed. The use of cross-discipline retrospective data reviews is a useful tool to identify patients who could benefit from being re-contacted over time for an updated cancer genetics assessment.
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