title: Implementing a screening tool for identifying patients at risk for hereditary breast and ovarian cancer: a statewide initiative.
abstract: BACKGROUND
  The Georgia Breast Cancer Genomic Health Consortium is a partnership created with funding from the Centers for Disease Control and Prevention (CDC) to the Georgia Department of Public Health to reduce cancer disparities among high-risk minority women. The project addresses young women at increased risk for hereditary breast and ovarian cancer (HBOC) syndrome through outreach efforts.
  
  
  METHODS
  The consortium provides education and collects surveillance data using the breast cancer genetics referral screening tool (B-RST) available at www.BreastCancerGeneScreen.org . The HBOC educational protocol was presented to 73 staff in 6 public health centers. Staff used the tool during the collection of medical history. Further family history assessments and testing for mutations in the BRCA1/2 genes were facilitated if appropriate.
  
  
  RESULTS
  Data was collected from November 2012 through December 2013, including 2,159 screened women. The majority of patients identified as black/African American and were 18-49 years old. Also, 6.0 % (n = 130) had positive screens, and 60.9 % (n = 67) of the 110 patients who agreed to be contacted provided a detailed family history. A total of 47 patients (42.7 %) met National Comprehensive Cancer Network guidelines when family history was clarified. Fourteen (12.7 %) underwent genetic testing; 1 patient was positive for a BRCA2 mutation, and 1 patient was found to carry a variant of uncertain significance.
  
  
  CONCLUSIONS
  The introduction of genomics practice within public health departments has provided access to comprehensive cancer care for uninsured individuals. The successful implementation of the B-RST into public health centers demonstrates the opportunity for integration of HBOC screening into primary care practices.
authors.affiliation: Department of Surgery, Emory University, Atlanta, GA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Brannon Traxler
authors.forename: Monique L
authors.initials: ML
authors.lastname: Martin
authors.forename: Alice S
authors.initials: AS
authors.lastname: Kerber
authors.forename: Cecelia A
authors.initials: CA
authors.lastname: Bellcross
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Crane
authors.forename: Victoria
authors.initials: V
authors.lastname: Green
authors.forename: Roland
authors.initials: R
authors.lastname: Matthews
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Paris
authors.forename: Sheryl G A
authors.initials: SG
authors.lastname: Gabram
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006284:Health Plan Implementation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D011379:Prognosis; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human