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Should we start performing universal germline mutation testing for all newly diagnosed breast cancer?

Given OlympiA trial with olaparib benefit for gBRCA+ patients? What are barriers that you foresee? In your practice who performs mutation testing and who counsels patients? Is this performed as part of tumor board or addressed by med onc during initial visits?
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How do you utilize germline BRCA testing in non-metastatic breast cancer?

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5 Answers
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Medical Oncology · Ellison Institute, LLC
Answered on

The OlympiA study resulted in a statistically significant iDFS and DDFS benefit with adjuvant olaparib vs placebo in high-risk, HER2-negative patients with gBRCA mutation. Given the notable improvement in outcomes, it is imperative that every potentially eligible patient be considered for adjuvant o...

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Medical Oncology · University of Texas MD Anderson Cancer Center
Answered on

The new NCCN guidelines indicate testing all metastatic breast cancer patients for PARP inhibitor consideration and testing eligible patients (per OlympiA study) for adjuvant Olaparib consideration.

There is no ideal way to provide genetic counseling for all eligible breast cancer patients that prese...

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Medical Oncology · Memorial Sloan Kettering Cancer Center
Answered on

One has to bear in mind that BRCA mutations are extremely uncommon in women who are over the age of 60 and do not meet NCCN criteria. Up to 40% of all women with breast cancer fall into this category. Also, not all breast cancer patients would have met the eligibility criteria for OlympiA. So while ...

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Medical Oncology · Columbia University Medical Center
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While universal germline testing for all newly diagnosed breast cancer may not be indicated, I think the majority of patients with a diagnosis of breast cancer should be offered testing given implications on treatment decision-making and future preventive care. I offer genetic testing as per NCCN gu...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
Answered on · Updated on

Should we start performing universal germline mutation testing for all newly diagnosed breast cancer? Short answer: No, not yet.

The argument that expanded multi-gene screening (80 genes or more) for all breast cancer patients should be balanced against the genetic testing for breast cancer patients...

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