Abstract
Increasing numbers of patients are having genetic testing ordered by a healthcare provider without following the traditional model of seeing a genetic counselor for pre-test counseling. It is important, however, to ensure that patients receive complete and accurate information about genetic testing and its implications on their medical management and the medical management of their relatives.\r The purpose of this qualitative study was to explore the experiences of breast cancer patients who had BRCA testing ordered without meeting with a genetic counselor. We interviewed four women who fit these criteria using a semi-structured interview guide to elicit information about the process they went through. We coded interviews based on questions asked of the participants and emergent themes. We analyzed the data looking for patterns and variations within these themes. \r Three main themes emerged: (1) the value genetic testing holds for the participants in informing surgical options, assessing risk to family members, determining their future risk of cancer, and curiosity; (2) the emotions patients experience about the genetic testing process in general and throughout the course of waiting for results, as well as receiving them; (3) patient interactions with providers and how they felt about what they should say and know about genetic testing.\r Through this research we found that some providers are ordering genetic testing for patients without following the traditional model of a genetic counselor providing pre-test and post-test counseling. This study suggests that BRCA testing ordered by non-genetic counselor healthcare providers is not detrimental to patients. Recommendations for future research entail a new model where providers order genetic testing at the time of medical necessity and then a genetic counselor delivers follow-up counseling. This process would facilitate patients being adequately informed about genetic testing, while also unifying the approach and increasing the education of providers.