Risk Counseling Tools for Contralateral Breast Cancer Risk After Genetic Testing
Mené auprès de 341 patientes atteintes d'un cancer du sein récemment diagnostiqué, cet essai randomisé évalue l'effet, sur la décision de subir une mastectomie controlatérale prophylactique, d'un outil visuel intégrant les résultats des tests génétiques et estimant le risque de développer un cancer du sein controlatéral
Increased rates of contralateral prophylactic mastectomies (CPM) have been reported in patients undergoing genetic testing, regardless of the testing result. With both expanded access to genetic testing and increasing support for universal genetic testing of all patients with newly diagnosed breast cancer, an unintended outcome may be continued increases in CPM. Weiss et al designed a randomized clinical trial to compare standard preoperative genetic counseling and testing vs genetic counseling and testing that incorporated a visual aid with an individualized quantification of contralateral breast cancer risk from a publicly available risk model, which they termed “quantitative counseling.” The authors found that the addition of the visual aid improved the patient’s ability to numerically quantify their predicted risk of a contralateral breast cancer, but neither the patient’s perceived qualitative risk (eg, very likely vs very unlikely) of developing a contralateral breast cancer nor likelihood of choosing to undergo CPM were significantly different with either counseling approach.
JAMA Network Open , éditorial en libre accès, 2026