Streamlined genetic education is effective in preparing women newly diagnosed with breast cancer for decision-making about treatment-focused genetic testing: A randomized controlled noninferiority trial

Abstract

Aims: Increasingly, women newly diagnosed with breast cancer are being offered treatment-focused genetic testing (“TFGT”). As the demand for TFGT increases, streamlined methods of genetic education are needed. This noninferiority trial aimed to compare the efficacy of providing brief written education about TFGT in preparing women for decision-making about TFGT to conventional pretest, face-to-face genetic counseling and to compare the resource-based costs of the two methods of education about TFGT. Methods: Women aged Results: This trial aimed to obtain recruit 64 patients in each group (128 in total) to provide 80% power to claim that the intervention is no worse than usual care, with respect to Decisional Conflict Scale scores (primary outcome). 135 women were included in the analysis, all of whom opted for TFGT. Decisional conflict about TFGT choice was not inferior in the IG compared to the UCG (noninferiority margin of -10, mean difference=2.45, 95% CI [-2.87, 7.76], p = 0.36). Costs per woman counseled in the IG were significantly lower (A$89), compared to the UCG (A$173; t(115)=6.02, P < 0.001). Conclusions: A streamlined model of educating women newly diagnosed with breast cancer about TFGT appears to be a cost-effective way of delivering education, while ensuring that women feel informed and supported in their decision-making, thus freeing resources for other women to access TFGT.L613440349 <br />