title: Are we being overly cautious? A qualitative inquiry into the experiences and perceptions of treatment-focused germline BRCA genetic testing amongst women recently diagnosed with breast cancer.
abstract: OBJECTIVE
  Women with breast cancer, who are found to be BRCA1/2 mutation carriers, have a high risk of ovarian cancer and metachronous breast cancer. Treatment-focused genetic testing (TFGT), offered around the time of diagnosis, allows genetic test results to inform surgical treatment decisions. However, concern has been raised that offering TFGT at this time may overly increase psychological burden. This study aimed to qualitatively explore women's attitudes and experiences of TFGT.
  
  
  METHODS
  Women who had been diagnosed with breast cancer at age 50 years or less undertook a semi-structured telephone interview (n = 26). The sample included women who had been offered TFGT, based on family history and/or other risk criteria (n = 14), and women who had been diagnosed within the past 6-12 months and had not been offered TFGT (n = 12). Interviews explored women's attitudes towards TFGT, perceived benefits and disadvantages, implications of TFGT and impact on surgical decision making. Interviews were transcribed verbatim and thematically analysed.
  
  
  RESULTS
  Women expressed positive attitudes towards TFGT and felt it was highly relevant to their surgical decision making. They did not feel that an offer of TFGT shortly after, or at the time of diagnosis, added undue psychological burden. The majority of women interviewed felt that TFGT should be incorporated into standard clinical care.
  
  
  CONCLUSIONS
  TFGT is viewed favourably by women newly diagnosed with breast cancer. Future randomized controlled trials are needed to examine the long-term impact of TFGT. We conclude that an offer of TFGT is not perceived as 'too much, too soon' by relevant patients.
authors.affiliation: Psychosocial Research Group, Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Zilliacus
authors.forename: B
authors.initials: B
authors.lastname: Meiser
authors.forename: M
authors.initials: M
authors.lastname: Gleeson
authors.forename: K
authors.initials: K
authors.lastname: Watts
authors.forename: K
authors.initials: K
authors.lastname: Tucker
authors.forename: E A
authors.initials: EA
authors.lastname: Lobb
authors.forename: G
authors.initials: G
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology* / Q000628:therapy; D003625:Data Collection; D003657:Decision Making; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D012189:Retrospective Studies; D013997:Time Factors