Scholarlink

<p>Contralateral prophylactic mastectomy (CPM) reduces contralateral breast cancer risk but improves survival only among young BRCA1/2 carriers. With expanded germline testing (GT) and increased use of oncologist-led and telehealth genetic services post-COVID, concerns remain about patients’ understanding of results and the impact on surgical decisions. We conducted a retrospective cohort study of 1,054 women with unilateral breast cancer who underwent GT at Columbia University Irving Medical Center from 2013–2022. Mean age was 51.2; 40.5% were non-Hispanic White (NHW), 28.4% Hispanic, 12.1% Black, and 10.3% Asian. Overall, 28% underwent CPM. Testing shifted from 99.7% in-person to 73.9% oncologist-led and 20.1% telehealth post-COVID. In multivariable analysis, CPM was associated with younger age, advanced stage, and pathogenic/likely pathogenic variants, but not with service delivery or VUS results. A trend toward higher CPM rates was observed among Hispanic versus NHW patients (OR = 1.34, 95% CI = 0.99-1.81, p = 0.055). Despite care delivery shifts, CPM rates remained stable.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of telehealth genetic counseling on contralateral prophylactic mastectomy rates among multi-ethnic breast cancer patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月1日

查看全文
  • Alissa Michel,
  • Vicky Ro,
  • Kelly Luo,
  • Meghna S. Trivedi,
  • Roshni Rao,
  • Elana Levinson,
  • Carrie Koval,
  • Rita Kukafka,
  • Katherine D. Crew

摘要

Contralateral prophylactic mastectomy (CPM) reduces contralateral breast cancer risk but improves survival only among young BRCA1/2 carriers. With expanded germline testing (GT) and increased use of oncologist-led and telehealth genetic services post-COVID, concerns remain about patients’ understanding of results and the impact on surgical decisions. We conducted a retrospective cohort study of 1,054 women with unilateral breast cancer who underwent GT at Columbia University Irving Medical Center from 2013–2022. Mean age was 51.2; 40.5% were non-Hispanic White (NHW), 28.4% Hispanic, 12.1% Black, and 10.3% Asian. Overall, 28% underwent CPM. Testing shifted from 99.7% in-person to 73.9% oncologist-led and 20.1% telehealth post-COVID. In multivariable analysis, CPM was associated with younger age, advanced stage, and pathogenic/likely pathogenic variants, but not with service delivery or VUS results. A trend toward higher CPM rates was observed among Hispanic versus NHW patients (OR = 1.34, 95% CI = 0.99-1.81, p = 0.055). Despite care delivery shifts, CPM rates remained stable.