Impact of Genetic Testing on Breast Cancer Surgery: Are the Variants Significant? - Abstract
Background: With increasing variant of unknown significance (VUS) genetic testing (GT) results, we evaluated the significance on surgical management for breast cancer patients. Methods: Patients from an IRB-approved database recruited from November 2000 to January 2017 with a VUS and history of breast cancer were identified. Self-reported questionnaire data was collected. Groups were compared using Chi-square, Fisher’s Exact or Kruskal-Wallis test by surgical type and timing of GT. Results: Seventy-nine VUS patients with breast cancer and questionnaire data were identified and studied. Initial surgical management was: 35 (44%) lumpectomies, 15 (19%) unilateral mastectomies and 29 (37%) bilateral mastectomies. Fifteen (19%) patients with bilateral breast cancer were excluded from analyses. Patients with VUS diagnosis before surgery, chose contralateral prophylactic mastectomy (CPM) more than diagnosis after surgery, but it was not statistically significant (50% vs 32%, p=0.215). Conclusions: A VUS influences, but not statistically significantly, surgical decision making. Appropriateness for CPM should not rely on a VUS result.