Evidence map›Paper›PMID 29611029›Full record

Trial reportBreast cancer research and treatment2018

Randomized trial of proactive rapid genetic counseling versus usual care for newly diagnosed breast cancer patients.

Marc D Schwartz, Beth N Peshkin, Claudine Isaacs, Shawna Willey, Heiddis B Valdimarsdottir, Rachel Nusbaum, Gillian Hooker, Suzanne O'Neill, Lina Jandorf, Scott P Kelly and 3 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Breast cancer research and treatment, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Decision coaching for people making healthcare decisions.The Cochrane database of systematic reviews · 2021
    Pooled it
  3. The Genetic Education for Men (GEM) Trial: Development of Web-Based Education for Untested Men in BRCA1/2-Positive Families.Journal of cancer education : the official journal of the American Association for Cancer Education · 2021
    Trial
  4. Article
  5. Interventions to improve delivery of cancer genetics services in the United States: A scoping review.Genetics in medicine : official journal of the American College of Medical Genetics · 2022
    Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Marc D SchwartzGeorgetown Lombardi Comprehensive Cancer, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, The Harris Building, Washington, DC, 20007, USA. schwartm@georgetown.edu.ORCID http://orcid.org/0000-0002-2735-5413
Beth N PeshkinGeorgetown Lombardi Comprehensive Cancer, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, The Harris Building, Washington, DC, 20007, USA.
Claudine IsaacsGeorgetown Lombardi Comprehensive Cancer, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, The Harris Building, Washington, DC, 20007, USA.
Shawna WilleyGeorgetown Lombardi Comprehensive Cancer, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, The Harris Building, Washington, DC, 20007, USA.
Heiddis B ValdimarsdottirDepartment of Population Health Science and Policy, Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Rachel NusbaumSchool of Medicine, University of Maryland, Baltimore, MD, USA.
Gillian HookerConcert Genetics, Inc, Franklin, TN, USA.
Suzanne O'NeillGeorgetown Lombardi Comprehensive Cancer, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, The Harris Building, Washington, DC, 20007, USA.
Lina JandorfDepartment of Population Health Science and Policy, Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Scott P KellyNational Cancer Institute, Bethesda, MD, USA.
Jessica HeinzmannAtlantic Health Services, Carol G. Simon Cancer Center, Summit, NJ, USA.
Aliza ZidellHackensack University Medical Center, Hackensack, NJ, USA.
Katia KhouryGeorgetown Lombardi Comprehensive Cancer, Georgetown University, 3300 Whitehaven St., NW, Suite 4100, The Harris Building, Washington, DC, 20007, USA.
Georgetown University · USAtlantic Health System · USConcert Pharmaceuticals (United States) · USHackensack University Medical Center · USIcahn School of Medicine at Mount Sinai · USNational Cancer Institute · USReykjavík University · ISUniversity of Maryland, Baltimore · US

Funding

Tissue Culture Shared ResourceP30CA051008 · NCI · GEORGETOWN UNIVERSITY · PI STEPHEN W BYERS · 1990 to 2026
$71.5M
Decisions &Outcomes of BRCA1/2 Test for Breast PatientsR01CA074861 · NCI · GEORGETOWN UNIVERSITY · PI SCHWARTZ, MARC D · 1997 to 2008
$3.5M
National Cancer Institute R01CA74861NCI NIH HHS P30 CA051008NCI NIH HHS R01 CA074861
6 · The paper itself

Abstract

purposeBreast cancer patients who carry BRCA1/BRCA2 gene mutations may consider bilateral mastectomy. Having bilateral mastectomy at the time of diagnosis not only reduces risk of a contralateral breast cancer, but can eliminate the need for radiation therapy and yield improved reconstruction options. However, most patients do not receive genetic counseling or testing at the time of their diagnosis. In this trial, we tested proactive rapid genetic counseling and testing (RGCT) in newly diagnosed breast cancer patients in order to facilitate pre-surgical genetic counseling and testing.

methodsWe recruited newly diagnosed breast cancer patients at increased risk for carrying a BRCA1/2 mutation. Of 379 eligible patients who completed a baseline survey, 330 agreed to randomization in a 2:1 ratio to RGCT (n = 220) versus UC (n = 108). Primary outcomes were genetic counseling and testing uptake and breast cancer surgical decisions.

resultsRGCT led to higher overall (83.8% vs. 54.6%; p < 0.0001) and pre-surgical (57.8% vs. 38.7%; p = 0.001) genetic counseling uptake compared to UC. Despite higher rates of genetic counseling, RGCT did not differ from UC in overall (54.1% vs. 49.1%, p > 0.10) or pre-surgical (30.6% vs. 27.4%, p > 0.10) receipt of genetic test results nor did they differ in uptake of bilateral mastectomy (26.6% vs. 21.8%, p > 0.10).

conclusionsAlthough RGCT yielded increased genetic counseling participation, this did not result in increased rates of pre-surgical genetic testing or impact surgical decisions. These data suggest that those patients most likely to opt for genetic testing at the time of diagnosis are being effectively identified by their surgeons.

Indexed as

Genetic CounselingStandard of CareAdolescentAdultAgedBiomarkers, TumorBreast NeoplasmsDecision MakingFemaleGenes, BRCA1Genes, BRCA2Genetic TestingHumansMastectomyMiddle AgedMutationBiomarkers, TumorBRCA1BRCA2Contralateral mastectomyGenetic counseling

Identifiers

PMID29611029
PMCPMC6026034
OpenAlexW2796279710

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.