Breast Cancer Research and Treatment

, Volume 169, Issue 1, pp 43–46 | Cite as

Impact of an embedded genetic counselor on breast cancer treatment

  • Holly J. PedersonEmail author
  • Najaah Hussain
  • Ryan Noss
  • Courtney Yanda
  • Colin O’Rourke
  • Charis Eng
  • Stephen R. Grobmyer
Preclinical study



We predicted that embedding a genetic counselor within our breast practice would improve identification of high-risk individuals, timeliness of care, and appropriateness of surgical decision making. The aim of this study is to compare cancer care between 2012 and 2014, prior to embedding a genetic counselor in the breast center and following the intervention, respectively.


A retrospective review of patients diagnosed with breast cancer in 2012 (n = 471) and 2014 (n = 440) was performed to assess patterns of medical genetics referral, compliance with referral, genetic testing findings, and impact on treatment.


Between 2012 and 2014, patients were 49% more likely to be referred to genetics, 66% more likely to follow through with their genetic counseling appointment, experienced a 73% reduction in wait times to genetic counseling visits and 69% more likely to have genetic testing results prior to surgery. Notably, while the number of genetic mutations identified was in the expected range over both time periods (9% of those tested in 2012 vs. 6.6% of those tested in 2014), there was a 31% reduction in time to treatment in 2014 vs. 2012.


Awareness of germline genetic mutations is critical in surgical decision making for newly diagnosed breast cancer patients. Having an experienced genetics specialist on site in a busy surgical breast clinic allows for timely access to genetic counseling and testing, and may have influenced time to treatment in our institution.


BRCA Surgery Mastectomy Lumpectomy Time to treatment Breast cancer Genetic testing Panel testing Genetic counseling 



Dr. Holly Pederson serves as a consultant to Myraid Genetics. Dr. Charis Eng serves as a consultant/advisor to N-of-One and holds stock ownership in Family Care Path, Inc. All other authors have no relevant disclosures to report.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Holly J. Pederson
    • 1
    • 2
    • 3
    • 7
    • 8
    Email author
  • Najaah Hussain
    • 8
    • 9
  • Ryan Noss
    • 2
    • 7
    • 9
  • Courtney Yanda
    • 1
    • 9
  • Colin O’Rourke
    • 4
    • 5
    • 9
  • Charis Eng
    • 2
    • 3
    • 7
    • 8
    • 9
  • Stephen R. Grobmyer
    • 1
    • 3
    • 6
    • 7
    • 8
    • 9
  1. 1.Division of Breast Services, Department of General SurgeryCleveland ClinicClevelandUSA
  2. 2.Genomic Medicine InstituteCleveland ClinicClevelandUSA
  3. 3.Taussig Cancer InstituteCleveland ClinicClevelandUSA
  4. 4.Department of Quantitative Health SciencesCleveland ClinicClevelandUSA
  5. 5.Fred Hutchinson Cancer Research CenterSeattleUSA
  6. 6.Department of SurgeryCleveland ClinicClevelandUSA
  7. 7.Department of Genetics and Genome SciencesCleveland ClinicClevelandUSA
  8. 8.CASE Comprehensive Cancer CenterCleveland ClinicClevelandUSA
  9. 9.Case Western Reserve University School of MedicineCleveland ClinicClevelandUSA

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