Jump to content

Choose locationSutter Lakeside Hospital
  • Sign in or Enroll
    • Open I want to choose my medical group or hospital
    • Clear my location
Change Location

We've expanded your view

You are now viewing all services in the Sutter Health network. You can change your location above to narrow your view to a medical group, hospital, city or zip.
Sutter Health
  • Video Visits
  • Find Doctors
  • Find Locations
  • Treatments & Services
  • Locations
  • Sign in or Enroll
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 Resources
    • Pay a Bill
    • Symptom Checker
    • Get Care Today
    • Diseases & Conditions
    • Health & Wellness
    • Classes & Events
    • Research & Clinical Trials
    • For Patients
    • About Sutter Health
    • Giving
    • Volunteering
    • Careers
    • News
    • For Medical Professionals
    • Other Business Services
Close Search
  • Home
  • Sutter Lakeside
  • Research
  • Breast Cancer
Content

Does the diagnosis of breast or ovarian cancer trigger referral to genetic counseling?

Description

Powell CB, Littell R, Hoodfar E, Sinclair F, Pressman A., Int J Gynecol Cancer. 23(3):431-6. doi: 10.1097/IGC.0b013e318280f2b4., 2013 Mar 01

Investigators

Alice R. Pressman, Ph.D., M.S.

Abstract

OBJECTIVE: Kaiser Permanente Northern California is a large integrated health care delivery system in the United States that has guidelines for referring women with newly diagnosed BRCA1-and BRCA2-associated cancers for genetic counseling. This study assesses adherence to genetic counseling referral guidelines within this health system.

METHODS: Chart review was performed to identify patients with cancer who met the following pathology-based Kaiser Permanente Northern California guidelines for referral for genetic counseling: invasive breast cancer, younger than age 40; nonmucinous epithelial ovarian, fallopian tube, or peritoneal cancer, younger than age 60; women with synchronous or metachronous primary cancers of the breast and ovaries; and male breast cancer. We assessed compliance with referral guidelines. An electronic notice was sent to the managing physician of patients with newly diagnosed cancer to assess the feasibility of this intervention.

RESULTS: A total of 340 patients were identified with breast cancer at younger than age 40 or with ovarian, peritoneal, or tubal cancer between January and June, 2008. Upon chart review, 105 of these patients met pathology-based criteria for referral to genetic counseling, of whom 47 (45%) were referred within the 2-year study period. Of the 67 subjects with breast cancer, 40 subjects (60%) were referred. In contrast, only 7 (21%) of 33 patients with ovarian cancer were referred (P < 0.001). A pilot study was performed to test the feasibility of notifying managing oncologists with an electronic letter alerting them of eligibility for genetic referral of patients with new diagnosis (n = 21). In the 3 to 6 months after this notification, 12 of these 21 patients were referred for counseling including 5 of 7 patients with a diagnosis of ovarian cancer.

CONCLUSION: There is a OBJECTIVE: Kaiser Permanente Northern California is a large integrated health care delivery system in the United States that has guidelines for referring women with newly diagnosed BRCA1-and BRCA2-associated cancers for genetic counseling. This study assesses adherence to genetic counseling referral guidelines within this health system.METHODS: Chart review was performed to identify patients with cancer who met the following pathology-based Kaiser Permanente Northern California guidelines for referral for genetic counseling: invasive breast cancer, younger than age 40; nonmucinous epithelial ovarian, fallopian tube, or peritoneal cancer, younger than age 60; women with synchronous or metachronous primary cancers of the breast and ovaries; and male breast cancer. We assessed compliance with referral guidelines. An electronic notice was sent to the managing physician of patients with newly diagnosed cancer to assess the feasibility of this intervention.RESULTS: A total of 340 patients were identified with breast cancer at younger than age 40 or with ovarian, peritoneal, or tubal cancer between January and June, 2008. Upon chart review, 105 of these patients met pathology-based criteria for referral to genetic counseling, of whom 47 (45%) were referred within the 2-year study period. Of the 67 subjects with breast cancer, 40 subjects (60%) were referred. In contrast, only 7 (21%) of 33 patients with ovarian cancer were referred (P < 0.001). A pilot study was performed to test the feasibility of notifying managing oncologists with an electronic letter alerting them of eligibility for genetic referral of patients with new diagnosis (n = 21). In the 3 to 6 months after this notification, 12 of these 21 patients were referred for counseling including 5 of 7 patients with a diagnosis of ovarian cancer.

CONCLUSION: There is a missed opportunity for referring patients to genetic counseling, especially among patients with ovarian cancer. A pilot study suggests that alerting treating physicians is a feasible strategy to increase appropriate referral.

Pubmed Abstract

Pubmed AbstractOpens New Window

Associated Topics

  • Breast Cancer
  • Cancer
  • Genetics
  • Ovarian Cancer

Related Publications

Breast cancer chemoprevention in primary care - assessing readiness for change.

Wang H, Snyder CF, Larson S, Vogel V, Kirchner HL, Sun H, Yan X. 24(6):283-288.
Qual Prim Care.
2016 Nov 01

Adiposity, inflammation, genetic variants and risk of post-menopausal breast cancer findings from a prospective-specimen-collection, retrospective-blinded-evaluation (PRoBE) design approach.

Yan XS, Barnholtz-Sloan J, Chu X, Li L, Colonie R, Webster J, Smelser D, Patel N, Prichard J, Stark A.
Springerplus. 2:638. doi: 10.1186/2193-1801-2-638. eCollection 2013.
2013 Nov 27

Higher absolute lymphocyte counts predict lower mortality from early-stage triple-negative breast cancer.

Afghahi A, Purington N, Han SS, Desai M, Pierson E, Mathur MB, Seto T, Thompson CA, Rigdon J, Telli ML, Badve SS, Curtis C, West RB, Horst K, Gomez SL, Ford JM, Sledge GW, Kurian AW.
Clin Cancer Res. pii: clincanres.1323.2017. doi: 10.1158/1078-0432.CCR-17-1323. [Epub ahead of print]
2018 Mar 26

Engaging patients in decisions about cancer screening: exploring the decision journey through the use of a patient portal.

Woolf SH, Krist AH, Lafata JE, Jones RM, Lehman RR, Hochheimer CJ, Sabo RT, Frosch DL, Zikmund-Fisher BJ, Longo DR.
Am J Prev Med. pii: S0749-3797(17)30650-5. doi: 10.1016/j.amepre.2017.10.027. [Epub ahead of print]
2017 Dec 11
The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

About Sutter

  • About Our Network
  • Annual Report
  • Awards
  • Community Benefit
  • Contact Us
  • News
  • Giving
  • Find Care

  • Birth Centers
  • Care Centers
  • Emergency Rooms
  • Hospitals
  • Imaging
  • Labs
  • Surgery Centers
  • Urgent Care
  • Walk-In Care
  • View All >
  • Featured Services

  • Behavioral Health
  • Cancer Services
  • Family Medicine
  • Home Health and Hospice
  • Orthopedics
  • Pediatrics
  • Pregnancy
  • Primary Care
  • Women's Health
  • View All >
  • Patient Resources

  • Accepted Health Plans
  • Classes and Events
  • Estimate Costs
  • Flu Resources
  • Health and Wellness
  • Medical Records
  • Medicare
  • My Health Online
  • Pay a Bill
  • Symptom Checker
  • Our Team

  • For Employees
  • Physician Careers
  • Recruiting Events
  • Sutter Careers
  • Vendors
  • Volunteers
    • ADA Accessibility
    • Contact
    • Privacy
    • Do Not Sell My Personal Information

    • LinkedIn Opens new window
    • YouTube Opens new window
    • Facebook Opens new window
    • Twitter Opens new window
    • Glassdoor Opens new window
    • Instagram Opens new window

    Copyright © 2021 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

    Cookie Policy

    We use cookies to give you the best possible user experience. By continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

    Privacy Policy Cookie Preferences