Oral Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Streamlined genetic education is effective in preparing women newly diagnosed with breast cancer for decision-making about treatment-focused genetic testing:  A randomized controlled non-inferiority trial (#39)

J Kirk 1 2 , VF Quinn 3 , B Meiser 3 , KM Tucker 4 , KJ Watts 1 , B Rahman 1 , M Peate 1 5 , C Saunders 6 , E Geelhoed 7 , M Gleeson 8 , K Barlow-Stewart 9 , M Field 10 , M Harris 11 , YC Antill 11 12 , L Cicciarelli 13 , K Crowe 14 , MT Bowen 15 , G Mitchell for the TFGT Collaborative Group 13 16
  1. Familial Cancer Service, Westmead Hospital, Westmead, NSW, Australia
  2. Centre for Cancer Research, The Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
  3. Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  4. Hereditary Cancer Clinic; Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
  5. Department of Obstetrics & Gynaecology, Royal Women’s Hospital, University of Melbourne, Parkville, VIC, Australia
  6. School of Surgery, University of Western Australia, Crawley, WA, Australia
  7. School of Population Health, University of Western Australia, Crawley, WA, Australia
  8. Hunter Family Cancer Service, Waratah, NSW, Australia
  9. Sydney Medical School-Northern, University of Sydney, Sydney, NSW, Australia
  10. Royal North Shore Hospital, St Leonards, NSW, Australia
  11. Monash Health, Melbourne, VIC, Australia
  12. Familial Cancer Centre, Cabrini Health, Melbourne, VIC, Australia
  13. Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne , VIC, Australia
  14. Genetic Health Queensland, Nambour General Hospital, Nambour, QLD, Australia
  15. School of Psychology, University of Sydney, Sydney, NSW, Australia
  16. Sir Peter MacCallum Dept of Oncology, University of Melbourne, Melbourne, VIC, Australia

Aims: Increasingly, women newly diagnosed with breast cancer are being offered treatment-focused genetic testing (‘TFGT’). As the demand for TFGT increases, streamlined methods of genetic education are needed.  This non-inferiority trial aimed to compare the efficacy of providing brief written education about TFGT in preparing women for decision-making about TFGT to conventional pre-test, face-to-face genetic counselling and to compare the resource-based costs of the two methods of education about TFGT.

Methods: Women aged

Results: This trial aimed to obtain recruit 64 patients in each group (128 in total) to provide 80% power to claim that the intervention is no worse than usual care, with respect to Decisional Conflict Scale scores (primary outcome).  135 women were included in the analysis, all of whom opted for TFGT. Decisional conflict about TFGT choice was not inferior in the IG compared to the UCG (non-inferiority margin of -10, Mean difference=2.45, 95% CI [-2.87, 7.76], p=.36).  Costs per woman counseled in the IG were significantly lower (A$89), compared to the UCG (A$173; t(115)=6.02, p<0.001).

Conclusions: A streamlined model of educating women newly diagnosed with breast cancer about TFGT appears to be a cost-effective way of delivering education, while ensuring that women feel informed and supported in their decision-making, thus freeing resources for other women to access TFGT.