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

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Abstract

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.

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  1. Abdominal and Breast Surgery; Advanced Gynecological Surgery; Breast Cancer; Breast Disease; Breast Oncology; Breast Pathology; Breast Surgery; Breast Surgical Oncology; Breasts; Cancer Genetics; Cancer Genetics Research; Cancer Medical Gynecology; Cancer/Head, Neck and Breast; Clinical Genetics; Clinical Oncology; Clinical Preventive Medicine; Counselling; Family and Marital Counselling; Gynecological Cancer; Gynecological Oncology; Gynecological Pathology; Gynecological Reproductive Endocrinology; Gynecological Surgery; Gynecology; Gynecology and Infertility; Gynecology Pathology and Cytology; Marital Counselling; Medical Genetics; Medical Oncology; Obstetrics and Gynecology; Oncology Imaging; Oncology/Breast Cancer; Ovarian Disorders; Reproductive Genetics; Reproductive Medicine; Surgical Oncology.

  2. Breast Cancer; Breast Disease; Clinical Preventive Health; Clinical Preventive Medicine; General Surgery; Gynecological Oncology; Gynecology; Marital and Sexual Counselling; Medical Genetics; Medical Oncology; Obstetrics and Gynecology; Obstetrics and Gynecology; Oncology; Preventive Medicine; Surgical Oncology; Women’s Cancerus; Women’s Issues.

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Web reference

  1. Canadian Association of Genetic Counselors (CAGC) (2013) https://cagc-accg.ca/

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Acknowledgments

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.

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Correspondence to Jolyane Blouin-Bougie.

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Appendix

Appendix

See Tables 7 and 8.

Table 7 Operational definitions of dependant variables and descriptive statistics
Table 8 Distribution of the variables measuring the frequency of use of risk communication formats across Canadian health professionals (post hoc—multiple comparisons tests)

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Amara, N., Blouin-Bougie, J., Jbilou, J. et al. The knowledge value-chain of genetic counseling for breast cancer: an empirical assessment of prediction and communication processes. Familial Cancer 15, 1–17 (2016). https://doi.org/10.1007/s10689-015-9835-7

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