Abstract
The point at which genetic counseling and testing is offered following a woman’s diagnosis of breast cancer may be of importance to her surgical decision-making. Whether she receives counseling between diagnosis and treatment or after treatment may be important with respect to her emotional well-being and may influence treatment decision-making options. Few studies have focused on patient attitudes toward the timing of their counseling sessions and receipt of test results or how the timing may influence any surgical decisions. The purposes of this study were to determine if women diagnosed with breast cancer have a preference about when they should receive genetic counseling and testing for hereditary breast cancer risk assessment and to gain a better understanding of whether genetic counseling and testing influence surgical decision making. We recruited 60 women from Women and Infants’ Hospital in Providence, RI, and the Facing Our Risk of Cancer Empowered online support group, who were diagnosed with breast cancer and received genetic counseling between September 2006 and September 2008, to participate in an online anonymous survey. The survey consisted of 31 multiple-choice and open-ended questions addressing demographics, personal and family cancer history and preferences for timing of genetic counseling. Most women (56%) preferred genetic counseling and testing prior to their surgery. None of our participants preferred counseling later than when they actually received it. Almost 80% of our sample who received counseling and testing prior to surgery (n=13) felt their counseling and genetic test result influenced their surgical decision. Only 15% of our sample felt psychologically overwhelmed by the information received during counseling regardless of whether they received counseling before or after surgery. Our results provide evidence to support the practice of referring women diagnosed with breast cancer to genetic counseling for BRCA testing prior to surgical treatment.