Evidence map›Paper›PMID 40588655›Full record

ArticleJournal of community genetics2025

Exploring the role of germline genetic testing in surgical decision making for early-stage invasive breast cancer: insights from a safety-net hospital.

Vineeth Kommidi, Manasa Kotamraju, Keerthana Chakka, Sharlene Dong, Alexa Badalamenti, Caitlin Mauer Hall, Ashley Quinn, Emily Goff, Chul Ahn, Ang Gao and 2 more

Abstract read
In one paragraph

Article in Journal of community genetics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

12 authors.

Vineeth Kommidi *Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA. vineeth.kommidi@utsouthwestern.edu.ORCID http://orcid.org/0000-0001-8297-2564
Manasa Kotamraju *University of Texas Southwestern Medical School, Dallas, Texas, USA.ORCID http://orcid.org/0009-0005-4555-0270
Keerthana ChakkaDepartment of Medicine, Northwestern University, Chicago, Illinois, USA.ORCID http://orcid.org/0000-0003-4203-8173
Sharlene DongDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID http://orcid.org/0000-0002-6983-6012
Alexa BadalamentiDivision of Cancer Genetics, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID http://orcid.org/0000-0002-1792-2226
Caitlin Mauer HallDivision of Cancer Genetics, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID http://orcid.org/0000-0002-4671-0353
Ashley QuinnDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID http://orcid.org/0000-0001-6555-511X
Emily GoffUniversity of Texas Southwestern Medical School, Dallas, Texas, USA.ORCID http://orcid.org/0000-0002-7198-6335
Chul AhnO'Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID http://orcid.org/0000-0002-2997-9203
Ang GaoO'Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID http://orcid.org/0000-0001-6530-8768
Deborah FarrDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID http://orcid.org/0000-0003-0571-3811
Samira SyedDivision of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID http://orcid.org/0000-0002-4645-7749

Funding

UT Southwestern Medical Center Simmons Comprehensive Cancer CenterP30CA142543 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI Kathryn Ann O'Donnell · 2010 to 2026
$53.7M
NCI NIH HHS P30 CA142543
6 · The paper itself

Abstract

Current guidelines recommend contralateral prophylactic mastectomy (CPM) for women with unilateral breast cancer who have pathogenic/likely pathogenic variants (PV) in high-risk genes, but not for those with variants of uncertain significance (VUS). However, VUS results can cause significant psychosocial distress, which may influence surgical decision-making. In safety-net settings, concerns about insurance coverage and additional social determinants of health may further impact CPM decisions. This study examines surgical trends among patients with early-stage invasive breast cancer who underwent genetic testing before surgery at a safety-net hospital in Dallas, Texas between 2012-2022. We performed a retrospective chart review of 300 early-stage breast cancer patients referred for genetic counseling, analyzing demographics, tumor characteristics, genetic testing results, and treatment. Descriptive statistics and regression analyses were performed. The cohort included 116 patients without mutations (control), 111 with VUS, and 73 with PV. 86.30% of PV patients, 30.63% of VUS patients, and 18.10% of the control group underwent CPM. Multivariate analysis identified PV (OR 26.35, 95% CI: 10.97-63.29, p < 0.0001), VUS (OR 2.35, 95% CI: 1.16-4.77, p = 0.0175), and age at diagnosis (OR 0.963, 95% CI: 0.934-0.993, p = 0.0168) as independent predictors of CPM. These findings suggest that factors beyond established guidelines may influence surgical decision-making, particularly for patients in safety-net hospital settings, underscoring the need for thorough provider and patient counseling.

Indexed as

Breast cancerGenetic counselingGenetic testingProphylactic mastectomyVariants of uncertain significance

Identifiers

PMID40588655
PMCPMC12569265

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.