PS5-11-09: Increasing rates of germline genetic testing in Veterans with breast cancer
Abstract
Despite increasing guideline support for germline testing in breast cancer—including universal testing recommendations from the American Society of Breast Surgeons and expanded criteria from NCCN and ASCO—uptake remains low, particularly among minority and male patients. The Veteran Affairs (VA) Breast and Gynecology Oncology System of Excellence (BGSoE) established in 2022, provides sub-specialized, evidence-based, comprehensive breast cancer care to Veterans throughout the United States via telehealth including rural and ethnic minorities. BGSoE is responsible for developing and updating the VA Breast cancer pathway, which supports universal genetic testing among patients diagnosed with breast cancer at any age. BGSoE utilizes Point of Care (POC) genetic testing and refers patients to the Comprehensive Genetic Service (CGS) for additional testing and counseling when needed. Veterans with breast cancer may undergo genetic testing through BGSoE and CGS or local community care providers. We aim to evaluate rates of guideline directed genetic testing among Veterans diagnosed with breast cancer.
We conducted a retrospective cohort analysis of breast cancer patients recorded in the VA national breast cancer dashboard from May 2020 to May 2025. We assessed rates of germline and somatic testing by treatment setting (VA, including BGSoE vs. community care), sex, ethnicity, and year of diagnosis.
Among 13,819 patients diagnosed with breast cancer, 1601 (11.6%) were male. Germline…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 13,819 participants or records.
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