Genetics-Supported Mainstream Testing Improves Access and Efficiency for Patients With Breast Cancer

Area of Science:

• Oncology
• Genetics
• Healthcare Delivery

Background:

• Growing demand for germline genetic testing in oncology exceeds current genetics service capacity.
• Mainstream genetic testing, with oncologists initiating testing and structured support, offers a solution to expand access.
• This model aims to maintain high-quality care while increasing patient reach.

Purpose of the Study:

• To compare a traditional genetics-led model with a genetics-supported mainstream model for germline genetic testing in breast cancer patients.
• To evaluate the impact of the mainstream model on test volume, turnaround times, and documentation compliance.
• To assess follow-up care for pathogenic variant carriers within both models.

Main Methods:

• Retrospective chart review of 805 breast cancer patients undergoing germline genetic testing.
• Comparison between a traditional model (genetics professional-led) and a mainstream model (oncologist-led with genetic counseling assistant support).
• Outcomes analyzed included test volume, turnaround times, consent and results disclosure documentation, and PV carrier follow-up.

Main Results:

• The mainstream model significantly reduced the time from diagnosis to consent (22.4 vs 59.5 days) and from consent to report (28.2 vs 35.2 days).
• Informed consent documentation was consistently high (>99%) in both models.
• While test volume increased substantially in the mainstream model, documentation of final result disclosure was lower (82.4% vs 100%), though all PV carriers received genetic counseling referrals.

Conclusions:

• A structured mainstream genetic testing model enhances access and reduces turnaround times for breast cancer patients.
• This model maintains quality standards for consent and test ordering, increasing overall test volume.
• Further improvements in result disclosure documentation by ordering providers are necessary.