Grant: Operating Grant

In 2011, it was expected that there would be 23,400 new cases of breast cancer diagnosed in Canada, of which approximately five percent are due to mutations in the BRCA1 and BRCA2 genes. There is recent evidence that these BRCA-associated breast cancers should receive different, more targeted treatments compared to women with sporadic breast cancer to decrease risks of new cancers and increase the chance of survival. However, due to the current genetic testing criteria and the length of time that genetic testing takes within Canada, testing at the time of breast cancer diagnosis is not generally offered, and if it is, test results are not available prior to breast cancer surgery. This may be leading to women electing for less personalized and targeted treatments, which has the potential to affect cancer-related mortality. With new genetic technology, rapid genetic testing for BRCA mutations is an option and genetic test results can be available within one week. However, it is unclear if provision of BRCA genetic test results at time of diagnosis would result in uptake of targeted surgical and medical treatments. The overall objective of the study is to evaluate the impact of rapid genetic testing for BRCA1 and BRCA2 in newly-diagnosed breast cancer patients on surgical and medical treatment choices, compared to women who receive standard genetic testing. Exploratory aims will include the evaluation of psychosocial functioning and satisfaction in women who receive rapid genetic testing at the time of breast cancer diagnosis. In this project we will compare the uptake of surgical and medical treatments two years after breast cancer diagnosis between BRCA mutation carriers who receive rapid genetic testing and those who receive standard genetic testing. Exploratory aims (psychosocial functioning and satisfaction) will be assessed in all women who participate in the rapid genetic testing (including BRCA1/2 positive and BRCA1/2 negative).