This study is expected to involve a total of 2,101 individuals: 89 (83 for testing the intervention and 6 who participated in interviews like Northwestern staff participants) breast cancer patients, 12 Northwestern staff,and 2,000 women who consented and participated in the genetics assessment screening survey using the tool, with a sub-cohort of 300 that may benefit from genetic assessment and/or testing based on the screening tool results.
All subjects will be assigned a unique study number to minimize the risk of a breach of confidentiality. This is the only anticipated risk to subjects participating in this study utilizing retrospective and prospective chart reviews and interviews.
TESTING THE INTERVENTION
Investigators will collect retrospective data for 83 breast cancer patients diagnosed who underwent BRCA testing and definitive breast cancer surgery at Northwestern between 07/01/2008 to 06/30/2010. This baseline information detailed on the Data Collection Form will be collected using EDW and NMFF and NMH medical record systems.
The intervention involves radiologists who convey pathology results to patients with suspected breast cancers. At the time the patient with a familial/ genetic risk is informed of a positive test result for breast cancer, the radiologist will provide information about genetic counseling and offer to send an educational handout via e-mail or regular mail. This intervention will be conducted with newly diagnosed breast cancer patients between 03/01/2011and 05/31/2012.
Investigators will prospectively collect data on these 83 breast cancer patients who are diagnosed, received BRCA testing, and had definitive surgery at Northwestern during the time of the intervention, 03/01/2011 and 05/31/2012. The EDW and NMFF and NMH medical record systems will be used to collect this information.
Because the intervention and retrospective and prospective chart reviews pose minimal risk to the subjects and locating the patients or having access to the patients would be time and cost prohibitive, a waiver of consent and HIPAA is requested.
ASSESS IMPACT OF THE INTERVENTION
Study investigators will conduct interviews with a total of 6 breast cancer patients and 12 Northwestern staff to determine if the intervention improved the care process. Written consent will be obtained from all interview participants. Participants will have the option of being audiotaped. Audiotaping is not required.
* Prior to the intervention, investigators will interview 6 breast cancer patients and 12 Northwestern staff to find out about the current care process and opinions/feedback on proposed intervention.
* Following the intervention, 6 patients and 12 staff will be interviewed using the same questions and format. It is acceptable that the individuals participating in the post-intervention interview are not the same as those participating in the pre-intervention interview.
INTERVENTION TEST/INTERVENTION IMPLEMENTATION
The intervention will be tested with women age 18 and older who have a history of genetic/familial risk and patients at the Lynn Sage Comprehensive Breast Center between March 1, 2013 and February 28, 2014. There will be no follow up on these patients after March 31, 2014..
1. Select breast center patients who consent to participate in this study will take a basic familial/genetic risk survey that follows NCCN guidelines (up to 2,000 patients will be consented into this study, with a sub-cohort of up to 300 who are identified to have a familial / genetic risk for breast cancer. If no risk is identified, the patient is not specifically informed of genetic counseling.
2. For study consented breast center patients with familial / genetic risk, the cancer genetics program will provide information about genetic counseling. The research staff will track those patients who receive information about genetic counseling.
