{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:27:12Z","timestamp":1791894432345,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Genetic evaluation and testing for hereditary breast and ovarian cancer (HBOC) remain suboptimal. The authors evaluated the feasibility of using a screening tool at a breast imaging center to increase HBOC assessment referrals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A brief questionnaire based on the National Comprehensive Cancer Network HBOC genetic counseling referral guidelines was developed and added to the standard intake forms of patients undergoing mammography at a community breast imaging center from 2012 through 2015. Patients who met the criteria in the guidelines were referred for genetic counseling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 34,851 patients were screened during the study period, and 1246 (4%) patients were found to be eligible for referral; 245 of these patients made a genetic counseling appointment, and 142 patients received genetic counseling. Forty patients (28%) had a personal history of breast cancer but were not previously tested. Following counseling, 105 patients were tested for <jats:italic>BRCA1<\/jats:italic>\/<jats:italic>2<\/jats:italic>. Eight patients (8%) tested positive for a pathogenic mutation and nine (9%) had a variant of unknown significance. Although they tested negative, many patients met the criteria to add breast magnetic resonance imaging to their screening due to greater than 20% lifetime breast cancer risk based on their family cancer history. This study led to improved clinical risk management in 67% of the patients who underwent genetic counseling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study shows that large\u2010scale screening of patients for HBOC syndromes at time of breast imaging is practical and highly feasible. The screening tool identified women with actionable <jats:italic>BRCA1<\/jats:italic>\/<jats:italic>2<\/jats:italic> mutations and mutation\u2010negative but high\u2010risk women, leading to significant changes in their risk management; these women would otherwise have been missed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay Summary<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Hereditary breast and ovarian cancer (HBOC) caused by pathogenic mutations in breast cancer genes (<jats:italic>BRCA1\/BRCA2<\/jats:italic>) increase an individual's lifetime risk of getting HBOC.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Identifying these high\u2010risk individuals and using proven preventive clinical risk management strategies can significantly reduce their lifetime risk of HBOC.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Using an innovative family cancer history questionnaire, 34,000 women were screened at a community breast imaging center, and genetic counseling and testing were provided to eligible women from the screening.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Several women at high risk for HBOC were identified and this led to positive clinical risk management changes.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>These women would have been missed if not for intervention.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33866","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T09:35:36Z","timestamp":1629711336000},"page":"94-102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Increasing referral of at\u2010risk women for genetic counseling and <i>BRCA<\/i> testing using a screening tool in a community breast imaging center"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5475-8509","authenticated-orcid":false,"given":"Banu K.","family":"Arun","sequence":"first","affiliation":[{"name":"Department of Breast Medical Oncology and Clinical Cancer Genetics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan K.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian E.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Houston Breast Screening Network, Department of Diagnostic Radiology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3459-1040","authenticated-orcid":false,"given":"Rachel D.","family":"Bluebond","sequence":"additional","affiliation":[{"name":"Department of Clinical Cancer Genetics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3041-8582","authenticated-orcid":false,"given":"Rebecca S. 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