Adherence to National Comprehensive Cancer Network Guidelines for BRCA testing among high risk breast Cancer patients: a retrospective chart review study
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Adherence to National Comprehensive Cancer Network Guidelines for BRCA testing among high risk breast Cancer patients: a retrospective chart review study
Background: Testing for BRCA variants canned impact treatment decisions for patients with breast cancer and affects the surveillance and prevention strategies for patients and their families. National Comprehensive Cancer Network (NCCN) guidelines recommend testing for patients at high risk of BRCA variants of the pathogen. We checked BRCA rate among high-risk breast cancer patients treated in community oncology testing practices.
Methods: We conducted a retrospective chart review of US oncologists using a community-based approach to a panel of physicians. high-risk breast cancer patients with a known family history of cancer and diagnosis of breast cancer at age ≥ 18 years of age between January 2013-October 2017 were included. We assess the proportion of patients tested for BRCA variants according to the NCCN guidelines.
Results: Charts of 63 doctors, an average of 16 years of practice, is inserted; 97% is a medical oncologist and 66.7% had a genetic counselor in their practice. We analyzed data for 410 randomly selected patients with an average age of 52 years; 95% were female, 74% were white, and 19% have Ashkenazi Jewish descent. Among all patients, 94% were tested for BRCA variants. The level of testing ranges from 78-100% in various high-risk groups; the lower level observed among Black patients (91%), male (92%), and patients were eligible NCCN based on family history of male breast cancer (78%) and prostate cancer (87%). We observed a higher rate of testing in patients treated by physicians with a genetic counselor in their practice (95% vs. 91%).
Conclusions: Adherence to NCCN guidelines BRCA testing is high in this group is dominated medical oncologist with extensive experience, with a high proportion have a genetic counselor in practice. testing levels may be increased in patients with risk factors associated with male relatives. a high level of compliance with the guidelines in the community setting is possible with the delivery model for genetic counseling and testing.
Adherence to National Comprehensive Cancer Network Guidelines for BRCA testing among high risk breast Cancer patients: a retrospective chart review study
propensity score analysis of the prognostic value of genomic tests for breast cancer in a diverse population using the data of the National Cancer Database
Background: Genomic tests like Oncotype Dx (ODX) and MammaPrint is used for the treatment of risk-adjusted decisions between patients with early breast cancer. However, to the authors’ knowledge, the agreement between the genomes of simple tests. Using real-world data, the authors conducted a comparative analysis of ODX and MammaPrint.
Methods: A group of women diagnosed with early stage, hormone receptor-positive breast cancer who received ODX or MammaPrint is established using the data of the National Cancer Database (NCDB) for the years 2010 to 2016. By using propensity score matching, two groups of patients with clinical characteristics and the same demographic defined: one group received MammaPrint ODX and more accepted. The authors examined the association between the use of ODX or MammaPrint test and overall survival using Cox models.
Results: Of the 451 693 eligible patients, approximately 45.3% and 1.8% receiving ODX receive MammaPrint test. ODX usage increased from 36.1% in 2010 to 49.9% in 2016, while the use of MammaPrint increased from 0.5% in 2010 to 3.3% in 2016. The authors matched patients who received ODX 5042 with 5042 patients who received MammaPrint. 5-year risk of death for a group of low-risk and low-risk group MammaPrint ODX was 3.4% and 4.7%, respectively.
Description: Recombinant beta Defensin-3 is a disulfide-linked monomer protein consisting of 46 amino acid residues, and migrates as an approximately 5 kDa protein under non-reducing and reducing conditions in SDS-PAGE. Optimized DNA sequence encoding Human beta Defensin-3 mature chain was expressed in E. coli.
Description: Recombinant beta Defensin-3 is a disulfide-linked monomer protein consisting of 46 amino acid residues, and migrates as an approximately 5 kDa protein under non-reducing and reducing conditions in SDS-PAGE. Optimized DNA sequence encoding Human beta Defensin-3 mature chain was expressed in E. coli.
Description: Interleukin-3 Human Recombinant produced in E.Coli is single, a non-glycosylated, Polypeptide chain containing 154 amino acids fragment (20-152) and having a total molecular mass of 17.3kDa and fused with a 20 aa N-terminal His tag. ;The IL3 His is purified by proprietary chromatographic techniques.
MammaPrint prognostic value is similar to the ODX; C-index of 0614 (95% confidence interval, 0.572 to .657) for MammaPrint and 0.581 (95% confidence interval, 0.530 to 0.631) for ODX. There are differences in assay performance ODX observed across race groups and / or ethnicity (P <0.001), with a slightly better performance recorded among African Americans compared to white and Hispanic individuals.
