REBECCA JOHNSON
CAPSTONE
Capstone Project Committee: Nancy Callanan, M.S., CGC; Sat Gupta, Ph.D.; Kimberly Schlesinger, M.D.; Asheley Supik, M.S., CGC
Background: Five to ten percent of breast cancer is found to be hereditary. Mutations in either BRCA1 or BRCA2 account for approximately half all hereditary breast cancers and 12-18% of ovarian cancer cases. The National Comprehensive Cancer Network (NCCN) has established guidelines for physicians and genetic counselors to aid them in deciding whether genetic counseling and testing for BRCA1/2 is appropriate.
Purpose: The goal of this study was to evaluate BRCA1/2 testing practices in a clinical cancer setting and determine the impact of a genetic counselor on BRCA1/2 testing.
Methods: This was a single-site, retrospective study that evaluated adherence to NCCN BRCA1/2 testing guidelines and whether adherence to these guidelines was impacted by the addition of a genetic counselor. This study utilized a cancer registry, electronic medical records and site-specific data sheets indicating patients who received BRCA1/2 testing.
Results: Overall, the majority (83.1%) of individuals with breast cancer who were eligible for BRCA1/2 testing were offered testing while 58.5% of eligible individuals with ovarian cancer were not offered testing. Individuals with ovarian cancer were not offered testing significantly more than those with breast cancer. All individuals seen by a genetic counselor were offered testing in adherence with the NCCN criteria. Other providers adhered to NCCN criteria in offering testing to 58.7% of eligible individuals. Adherence to NCCN criteria by other providers varied with provider specialty.
Discussion: This study demonstrates that there is a need for additional educational efforts to increase the adherence by non-genetic counselor providers to NCCN guidelines for BRCA1/2 testing for patients who qualify for testing based on their personal cancer diagnosis.
Since Graduation
Following graduation in 2014, Becca began her career as a pediatric genetic counselor at Sanford Children’s hospital in Sioux Falls, SD. A couple of years into her career she changed roles and started working as the assistant program director for the Augustana-Sanford genetic counseling program. At that time, she also switched her clinical focus and started working in an OB-GYN clinic seeing patients for various primary care indications. This past spring, another change in roles occurred and she is now serving as the Program Director for the Augustana-Sanford graduate program. She loves her time working with students, faculty and supervisors and credits an incredible experience at UNCG as one of the reasons for this career choice.
Becca and her husband have a four-year-old daughter and one-year-old son. They enjoy time spent outside, trying out new recipes in the kitchen and lots of time spent reading (mostly children’s books!).