Genetic testing and surgical decision making in breast cancer

Abstract

Breast cancer is the most common cancer in women. While advances have been made in its detection and treatment, breast cancer is still responsible for significant mortality annually. One aspect of treatment that needs to be considered is the type of operation a woman should undergo. Studies have shown that fewer women are choosing breast conserving surgery even though the survival rate is equivalent compared to bilateral mastectomy. One component that can help guide this decision and establish those that would benefit from contralateral risk reducing mastectomy is genetic testing. Many studies have found that high penetrance mutations influence the type of operation women undergo. There have, however, been no studies investigating whether undergoing genetic testing and not carrying a high penetrance mutation influences one’s surgical decision. This proposed study is a one-year prospective cohort study that aims to determine if undergoing genetic testing and not carrying a high penetrance mutation increases a woman’s likelihood of choosing contralateral risk reducing mastectomy. This study will help understand how women use genetic counseling and testing information to guide their surgical decision. In addition, this study will examine if future studies are needed to improve breast cancer treatment counseling to decrease unnecessary surgery, surgical complications and decrease cost.