Role of the general practitioner in the care of BRCA1 and BRCA2 mutation carriers: General practitioner and patient perspectives

Mol Genet Genomic Med. 2018 Nov;6(6):957-965. doi: 10.1002/mgg3.464. Epub 2018 Oct 11.

Abstract

Background: General practitioners (GPs) have an increasing role in referring patients with putative mutation in BRCA1/2 genes for genetics consultation and for long-term follow-up of mutation carriers.

Methods: We compared the expectations of the GPs' role according to BRCA1/2 mutation carriers and to GPs themselves.

Results: Overall, 38% (58/152) of eligible GPs and 70% (176/252) of eligible patients were surveyed. Although 81% of GPs collected the family history, only 24% considered that they know criteria indicating genetics consultation and 39% sufficient knowledge of BRCA1/2 guidelines to answer patients' questions. Twelve% of GPs were aware of the French national guidelines. Among unsatisfied patients, 40% felt that their GP was able to answer (moderately, sufficiently, or completely) specific questions about BRCA1/2 care as compared with 81% in satisfied patients. Only 33% of GPs reported being informed directly by the geneticist about the patients' results. GPs' main expectations for their role in BRCA1/2 carrier care were psychological support and informing relatives about screening (72% and 71%, respectively), which contrasts with the perceptions of patients, who mainly requested medical advice for BRCA1/2-related care (51%).

Conclusion: There is an important need for GP training and enhancing interactions between GPs and geneticists to improve the GP's role in BRCA1/2 screening and management.

Keywords: BRCA1; BRCA2; general practitioners; genetic screening; hereditary breast and ovarian cancer syndrome.

Publication types

  • Clinical Trial
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics*
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / genetics
  • Breast Neoplasms / psychology*
  • Female
  • General Practitioners / psychology
  • General Practitioners / standards*
  • Genetic Carrier Screening / standards*
  • Genetic Counseling / psychology
  • Genetic Counseling / standards*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Middle Aged
  • Referral and Consultation / standards

Substances

  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human