DNA-testing for BRCA1/2 prior to genetic counselling in patients with breast cancer: design of an intervention study, DNA-direct
pmid: 22569005
pmc: PMC3416735
DNA-testing for BRCA1/2 prior to genetic counselling in patients with breast cancer: design of an intervention study, DNA-direct
Abstract Background Current practice for patients with breast cancer referred for genetic counseling, includes face-to-face consultations with a genetic counselor prior to and following DNA-testing. This is based on guidelines regarding Huntington’s disease in anticipation of high psychosocial impact of DNA-testing for mutations in BRCA1/2 genes. The initial consultation covers generic information regarding hereditary breast cancer and the (im)possibilities of DNA-testing, prior to such testing. Patients with breast cancer may see this information as irrelevant or unnecessary because individual genetic advice depends on DNA-test results. Also, verbal information is not always remembered well by patients. A different format for this information prior to DNA-testing is possible: replacing initial face-to-face genetic counseling (DNA-intake procedure) by telephone, written and digital information sent to patients’ homes (DNA-direct procedure). Methods/design In this intervention study, 150 patients with breast cancer referred to the department of Clinical Genetics of the Radboud University Nijmegen Medical Centre are given the choice between two procedures, DNA-direct (intervention group) or DNA-intake (usual care, control group). During a triage telephone call, patients are excluded if they have problems with Dutch text, family communication, or of psychological or psychiatric nature. Primary outcome measures are satisfaction and psychological distress. Secondary outcome measures are determinants for the participant’s choice of procedure, waiting and processing times, and family characteristics. Data are collected by self-report questionnaires at baseline and following completion of genetic counseling. A minority of participants will receive an invitation for a 30 min semi-structured telephone interview, e.g. confirmed carriers of a BRCA1/2 mutation, and those who report problems with the procedure. Discussion This study compares current practice of an intake consultation (DNA-intake) to a home informational package of telephone, written and digital information (DNA-direct) prior to DNA-testing in patients with breast cancer. The aim is to determine whether DNA-direct is an acceptable procedure for BRCA1/2 testing, in order to provide customized care to patients with breast cancer, cutting down on the period of uncertainty during this diagnostic process. Trial registration The study is registered at the Dutch Trial Registry http://www.trialregister.nl (NTR3018).
- Radboud University Nijmegen Netherlands
- Radboud University Nijmegen Medical Centre Netherlands
Counseling, NCMLS 6: Genetics and epigenetic pathways of disease IGMD 3: Genomic disorders and inherited multi-system disorders, NCMLS 6: Genetics and epigenetic pathways of disease ONCOL 3: Translational research, ONCOL 3: Translational research IGMD 3: Genomic disorders and inherited multi-system disorders, Breast Neoplasms, Genetic Counseling, ONCOL 1: Hereditary cancer and cancer-related syndromes NCMLS 6: Genetics and epigenetic pathways of disease, Study Protocol, Breast cancer, Genetic, ONCOL 1: Hereditary cancer and cancer-related syndromes, Surveys and Questionnaires, Obstetrics and Gynaecology, Humans, Genetic Testing, ONCOL 4: Quality of Care, Netherlands, Medicine(all), BRCA2 Protein, <it>BRCA</it>, BRCA1 Protein, NCEBP 8: Psychological determinants of chronic illness ONCOL 4: Quality of Care, DNA, Gynecology and obstetrics, DNA, Neoplasm, Hereditary, ONCOL 3: Translational research, Research Design, RG1-991, Female, Public aspects of medicine, RA1-1270, Follow-Up Studies
Counseling, NCMLS 6: Genetics and epigenetic pathways of disease IGMD 3: Genomic disorders and inherited multi-system disorders, NCMLS 6: Genetics and epigenetic pathways of disease ONCOL 3: Translational research, ONCOL 3: Translational research IGMD 3: Genomic disorders and inherited multi-system disorders, Breast Neoplasms, Genetic Counseling, ONCOL 1: Hereditary cancer and cancer-related syndromes NCMLS 6: Genetics and epigenetic pathways of disease, Study Protocol, Breast cancer, Genetic, ONCOL 1: Hereditary cancer and cancer-related syndromes, Surveys and Questionnaires, Obstetrics and Gynaecology, Humans, Genetic Testing, ONCOL 4: Quality of Care, Netherlands, Medicine(all), BRCA2 Protein, <it>BRCA</it>, BRCA1 Protein, NCEBP 8: Psychological determinants of chronic illness ONCOL 4: Quality of Care, DNA, Gynecology and obstetrics, DNA, Neoplasm, Hereditary, ONCOL 3: Translational research, Research Design, RG1-991, Female, Public aspects of medicine, RA1-1270, Follow-Up Studies
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