Mainstreamed Genetic Testing of Breast Cancer Patients in Two Hospitals in South Eastern Norway

Abstract Background: Identification of a BRCA mutation in a breast cancer patient provides critical information both for treatment decisions and for prevention of new cancers. In South Eastern Norway, genetic testing of the BRCA genes has been mainstreamed into breast cancer care. Testing is offered directly to the patients by the surgeon or oncologist if they fulfill national criteria. The purpose of this study was to investigate to what extent BC patients who fulfill these criteria are offered testing. Methods: Three hundred and sixty one BC patients diagnosed during the first half of 2016 and 2017 at one university and one regional hospital in South Eastern Norway were included in the study. Data were collected on whether the patients fulfilled the criteria, whether they had been offered testing and if they had accepted testing. Results: For the two hospitals combined, 75% of BC patients who fulfilled the criteria were offered testing. The numbers were 63% at the regional hospital and 90% at the university hospital. Fifty two percent of the patients who were not offered testing even though they fulfilled the criteria and were younger than 50 years at time of diagnosis. As many as 95% of the patients who were offered testing, wanted to be tested. Conclusions: The majority of patients who fulfilled the criteria were offered testing. However, there were differences in rates of testing between the hospitals that affected all groups of patients. This indicates that diagnostic genetic testing is not equally available to all BC patients. We suggest that efforts should be made to raise awareness of and improve routines for genetic testing of BC patients in Norway.