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Can Breast Surgeons Provide Breast Cancer Genetic Testing? An American Society of Breast Surgeons Survey

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Whether breast cancer surgeons are adequately trained, skilled, and experienced to provide breast cancer genetic assessment, testing, and counseling came under debate in September 2013 when a major third-party payer excluded nongenetics specialists from ordering such testing. A literature search having failed to uncover any study on breast surgeons’ skill and practice in this area, the American Society of Breast Surgeons (ASBrS) surveyed its members on their experience with the recognized crucial components of such testing.

Methods

In late 2013, ASBrS e-mailed a link to an online questionnaire to its U.S. members (n = 2,603) requesting a self-assessment of skills and experience in genetic assessment, testing, interpretation, and counseling. After approximately 6 weeks, the results were collated and evaluated.

Results

By January 2, 2014, 907 responses (34.84 %) had arrived from breast surgeons nationwide working in academic settings (20 %), solo or small group private practice (39 %), large multispecialty groups (18 %), and other settings. More than half said they performed 3-generation pedigrees, ordered genetic testing, and provided pre- and posttest counseling. Most noted that they would welcome continuing educational support in genetics.

Conclusions

Currently the majority of breast surgeons provide genetic counseling and testing services to their patients. They report practices that meet or exceed recognized guidelines, including the necessary elements and processes for best practices in breast cancer genetics test counseling. Because breast cancer genetic testing is grossly underutilized relative to the size of the U.S. BRCA mutation carrier population, these appropriate services should not be restricted but rather supported and expanded.

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Acknowledgment

The survey described in this article was funded, produced, disseminated, and collated by the American Society of Breast Surgeons, Columbia, Maryland. The authors are grateful to the Board of Directors of the American Society of Breast Surgeons for advancing the genetic testing survey project, reviewing a draft of this article, and lending critical guidance. Important suggestions were made by board members Hiram S. Cody III, MD, FACS; Sarah Fredrickson, MD, FACS; V. Suzanne Klimberg, MD, FACS; Funda Merrick-Bernstram, MD, FACS; and especially Steven L. Chen, MD, MBA, FACS, and Jeffrey Landercasper, MD, FACS. The staff of the American Society of Breast Surgeons contributed invaluable technical development, operational management, and data management of the Society’s Genetic Counseling and Testing Survey. Marcia Ringel provided editorial support.

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Dallas Breast Center and Dallas Surgical Group, Dallas, TX, USA

    Peter D. Beitsch MD, FACS

  2. Nashville Breast Center, Nashville, TN, USA

    Pat W. Whitworth MD

Authors
  1. Peter D. Beitsch MD, FACS
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  2. Pat W. Whitworth MD
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Correspondence to Pat W. Whitworth MD.

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Beitsch, P.D., Whitworth, P.W. Can Breast Surgeons Provide Breast Cancer Genetic Testing? An American Society of Breast Surgeons Survey. Ann Surg Oncol 21, 4104–4108 (2014). https://doi.org/10.1245/s10434-014-3711-9

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  • DOI: https://doi.org/10.1245/s10434-014-3711-9

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