The Importance of Paternal Family History in Hereditary Breast Cancer Is Underappreciated by Health Care Professionals

Abstract

Objectives: Cancer genetics clinics have been established in many major oncology centers worldwide in recent years. For such specialized clinics to fulfill their function, primary care physicians need to identify high-risk patients for referral. Methods: We conducted a survey to evaluate the level of awareness of breast cancer risk factors and hereditary breast cancer among health care providers and patients. Results: 284 health care professionals, 221 medical students, 104 breast cancer patients and 177 cancer-free women participated in the study. Less than half of the patients with breast cancer were aware of their risk for another breast cancer or of the increased breast cancer risk of their sisters and daughters. Less than one quarter of the health care professionals and medical students knew the importance of paternal family history in the evaluation for hereditary breast cancer. Only about half of the health care professionals and medical students and less than one third of the breast cancer patients and cancer-free women knew about genetic testing and prophylactic mastectomy as options for women at risk for hereditary breast cancer. Conclusions: Health care providers and medical students lack basic genetic knowledge and are not aware of emerging diagnostic and preventive options for hereditary breast cancer. Inclusion of cancer genetics in the continuing medical education of health care providers is important to promote such awareness.

Hereditary breast/ovarian and colorectal cancer genetics knowledge in a national sample of US physicians

“…Our findings of uncertainty and limited accuracy related to clinical genetics knowledge are consistent with reported knowledge levels in several regional, 13 15-17 national, 18 and international [19][20][21][22][23] surveys conducted at a comparable timepoint. In the aggregate, these findings are not unexpected given the relatively recent identification of major breast/ ovarian and colorectal cancer susceptibility genes 24 25 or updated practice guidelines, [26][27][28][29] should increase cancer genetics knowledge among a broader spectrum of physicians.…”

BRCA genetic testing of individuals from families with low prevalence of cancer: experiences of carriers and implications for population screening

“…14 Health-care providers may not appreciate the importance of paternal family history of cancer. 15,16 In addition, the family structure could explain low cancer prevalence (e.g., small families or families with preponderance of male individuals). 17 Therefore, current testing criteria for asymptomatic women may miss potential carriers who are, in fact, at risk.…”

Genetic education and nongenetic health professionals: Educational providers and curricula in Europe

“…9 Nongenetics specialist doctors with cases involving genetic issues demonstrated poor documentation, did not refer for genetic counseling, and did not consider wider implications for other family members. 8 These findings have been supported in other countries such as Australia, 10 Netherlands, 11,12 Singapore, 13 and USA. 14 -17 Despite this, confidence in dealing with genetic issues was relatively high among US medical students and residents (59%, n ϭ 85) 18 and German gynecologists (66%, n ϭ 172), 19 while 31% of US physicians had ordered or referred for genetic testing in the previous 12 months.…”