title: A statewide survey of practitioners to assess knowledge and clinical practices regarding hereditary breast and ovarian cancer.
abstract: OBJECTIVE
  This study describes practitioner knowledge and practices related to BRCA testing and management and explores how training may contribute to practice patterns.
  
  
  METHODS
  A survey was mailed to all BRCA testing providers in Florida listed in a publicly available directory. Descriptive statistics characterized participants and their responses.
  
  
  RESULTS
  Of the 87 respondents, most were community-based physicians or nurse practitioners. Regarding BRCA mutations, the majority (96%) recognized paternal inheritance and 61% accurately estimated mutation prevalence. For a 35-year-old unaffected BRCA mutation carrier, the majority followed national management guidelines. However, 65% also recommended breast ultrasonography. Fewer than 40% recognized the need for comprehensive rearrangement testing when BRACAnalysis(®) was negative in a woman at 30% risk. Finally, fewer than 15% recognized appropriate testing for a BRCA variant of uncertain significance. Responses appeared to be positively impacted by presence and type of cancer genetics training.
  
  
  CONCLUSIONS
  In our sample of providers who order BRCA testing, knowledge gaps in BRCA prevalence estimates and appropriate screening, testing, and results interpretation were identified. Our data suggest the need to increase regulation and oversight of genetic testing services at a policy level, and are consistent with case reports that reveal liability risks when genetic testing is conducted without adequate knowledge and training.
authors: Moffitt Cancer Center, 12902 Magnolia Drive MRC-CANCONT, Tampa, FL 33612, USA. tuya.pal@moffitt.org
authors: Tuya
authors: T
authors: Pal
authors: Deborah
authors: D
authors: Cragun
authors: Courtney
authors: C
authors: Lewis
authors: Andrea
authors: A
authors: Doty
authors: Maria
authors: M
authors: Rodriguez
authors: Cristi
authors: C
authors: Radford
authors: Zachary
authors: Z
authors: Thompson
authors: Jongphil
authors: J
authors: Kim
authors: Susan T
authors: ST
authors: Vadaparampil
mesh_terms: D000328:Adult; D019313:BRCA1 Protein / Q000235:genetics; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D005260:Female; D005431:Florida; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D010818:Practice Patterns, Physicians'; D012307:Risk Factors
chemical_list: D019313:BRCA1 Protein