Familial Cancer

, Volume 15, Issue 1, pp 1–17 | Cite as

The knowledge value-chain of genetic counseling for breast cancer: an empirical assessment of prediction and communication processes

  • Nabil Amara
  • Jolyane Blouin-Bougie
  • Jalila Jbilou
  • Norrin Halilem
  • Jacques Simard
  • Réjean Landry
Original Article


The aim of this paper is twofold: to analyze the genetic counseling process for breast cancer with a theoretical knowledge transfer lens and to compare generalists, medical specialists, and genetic counselors with regards to their genetic counseling practices. This paper presents the genetic counseling process occurring within a chain of value-adding activities of four main stages describing health professionals’ clinical practices: (1) evaluation, (2) investigation, (3) information, and (4) decision. It also presents the results of a cross-sectional study based on a Canadian medical doctors and genetic counselors survey (n = 176) realized between July 2012 and March 2013. The statistical exercise included descriptive statistics, one-way ANOVA and post-hoc tests. The results indicate that even though all types of health professionals are involved in the entire process of genetic counseling for breast cancer, genetic counselors are more involved in the evaluation of breast cancer risk, while medical doctors are more active in the decision toward breast cancer risk management strategies. The results secondly demonstrate the relevance and the key role of genetic counselors in the care provided to women at-risk of familial breast cancer. This paper presents an integrative framework to understand the current process of genetic counseling for breast cancer in Canada, and to shed light on how and where health professionals contribute to the process. It also offers a starting point for assessing clinical practices in genetic counseling in order to establish more clearly where and to what extent efforts should be undertaken to implement future genetic services.


Genetic counseling Canadian health care providers Familial breast cancer Risk prediction Risk communication Knowledge management Knowledge value chain 



This research was supported by the Canadian Institutes of Health Research as a part of the CIHR Team in Familial Risks of Breast Cancer Grant (CRN-8752–1) and the Ministry of Economic Development, Innovation and Export Trade of Quebec—Grant #PSR-SIIRI-701.

Compliance with ethical standards

Conflict of interest



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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Nabil Amara
    • 1
  • Jolyane Blouin-Bougie
    • 1
  • Jalila Jbilou
    • 2
  • Norrin Halilem
    • 1
  • Jacques Simard
    • 3
  • Réjean Landry
    • 1
  1. 1.Department of Management, Pavillon Palasis-PrinceLaval UniversityQuebecCanada
  2. 2.New Brunswick Medical Training Centre and School of Psychology, University of MonctionMonctonCanada
  3. 3.Cancer Genomics Laboratory, Department of Molecular MedicineLaval UniversityQuebecCanada

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