Should genetic testing be offered to all patients with breast cancer?

Conducting multigene testing on breast cancer patients when they are diagnosed is cost effective and could potentially save the lives of thousands. But many patients are not offered the testing based on existing criteria, which means people carrying cancer genes are not given the opportunity to find out if they are carriers.

Multigene testing includes an evaluation for the BRCA1, BRCA2 and PALB2 genes. The genes have been linked to inherited cases of cancer. Mutations to the genes can put men and women at a higher risk of breast cancers as well as other cancers.

Currently, testing is restricted based on a patient’s family history or clinical criteria. While certain Breast Surgeon societies recommend genetic testing for all, some does not.

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Dr. Ranjit Manchanda, a lead researcher and professor, said that about 50 percent of BRCA carriers do not meet the existing criteria to qualify for genetic testing. As a result, about half of them are at risk but don’t know it. Additionally, only 20 to 30 percent of patients who meet the criteria are referred for and access BRCA testing.

He also says that all breast cancer patients should be offered the option of multigene testing. This approach will save many more lives and prevent many more breast and ovarian cancers than the current clinical approach. According to him there is no benefit of testing being restricted.

A study conducted by an Oncology society assessed data from 959 breast cancer patients and found that only 49.95 percent met the testing criteria. And recommended complete genetic testing.

Another study was based on data from more than 83,000 women on cancer registries. About one-quarter of them with breast cancer had genetic testing.

Several organisations recommend genetic testing for ovarian cancer, but there are fewer that do for breast cancer patients.

Dr. Peter D. Beitsch, a surgical oncologist from Texas who was part of a supporting study told that he agrees that breast cancer patients need genetic testing upon diagnosis. The new research is in line with his findings.