What happens after referral? Completion rates of genetic counseling evaluations in breast cancer patients

Breast cancer (BC) is a common and often life-altering diagnosis for affected women and their families. Studies have indicated approximately 10% of breast cancer cases are inheritable. When patients are aware of their genetic status early, they are better equipped to make therapy decisions related to their cancer. Additionally, if patients are aware of pathogenic mutations, they can evaluate options such as chemoprevention with endocrine agents, prophylactic surgery, and have the ability to inform family members of their potential risk. Unfortunately, the shortage of genetic counselors has led to a large clinical demand delaying consultation. Although our institution employs genetic counselors on staff, the national shortage of counselors with this expertise has led to a disproportionate availability of providers to meet the clinical volume. This can lead to genetic counseling consultation often occurring beyond the patient's cancer treatment phase. Therefore, we sought to evaluate our referral patterns in an effort to determine whether qualifying patients were scheduled, evaluate delays in consultation, examine completion rates for genetic testing, and assess whether genetic counseling affected their subsequent care.