The initiator and timing of referral to breast cancer genetic counselling: an exploration of everyday person-centered practice.

Objective: The referral process for genetic counselling in breast cancer patients may be compromised by patient-related factors, like patient’s age, referral initiative or cancer history. This study aimed to characterize this referral process in daily clinical practice. Methods: During genetic counselling a checklist was filled in for each consecutive counselee affected with breast cancer assessing educational level, the initiator for referral and the ethnic background as reported by the counselee. Chi-square tests were used to assess associations between patient-related factors and initiator of referral and timing of genetic counselling. Results: Included were 96 consecutive breast cancer patients referred to cancer genetic counselling: 52% of them were referred on their own initiative versus 48% on their doctor’s initiative. There was no significant relationship between initiator of referral and time since diagnosis, age at time of diagnosis, number of first-degree female relatives and number of first degree relatives affected by any cancer. Discussion: Patients’ interest in genetic testing is not clearly related with time since diagnosis. Family history seems to play a role in the timing for referral. Conclusion: At one out of two breast cancer patients plays a major role in the referral for genetic counselling. However, we did not establish a relationship between initiative for referral and time since diagnosis. (aut. ref.)