{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:09:42Z","timestamp":1788448182255,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Adjuvant olaparib has been approved in the US since 2022 for patients with high-risk HER2-negative early-stage breast cancer (eBC) with germline mutation in\n                      <jats:italic>BRCA1<\/jats:italic>\n                      or\n                      <jats:italic>BRCA2<\/jats:italic>\n                      (g\n                      <jats:italic>BRCA<\/jats:italic>\n                      m), and contemporary real-world data are needed regarding\n                      <jats:italic>BRCA<\/jats:italic>\n                      m testing patterns,\n                      <jats:italic>BRCA<\/jats:italic>\n                      m prevalence, and therapy selection for HER2-negative eBC in the US.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study used a longitudinal, real-world dataset from US community healthcare systems to describe characteristics and\n                      <jats:italic>BRCA<\/jats:italic>\n                      m testing of adults with initial diagnosis from 1-Jan-2022 to 22-Jan-2024 of clinical stage I-III HER2-negative BC. Patients with unknown hormone receptor (HR) status, enrolled in a clinical trial, or with lobular carcinoma\n                      <jats:italic>in situ<\/jats:italic>\n                      or other primary cancer were excluded. Subsequent therapy was described by\n                      <jats:italic>BRCA<\/jats:italic>\n                      m status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 3741 patients with HER2-negative eBC, 51% and 56% were\n                      <jats:italic>BRCA<\/jats:italic>\n                      m tested in 2022 and 2023, respectively, &amp;gt;99% for germline\n                      <jats:italic>BRCA<\/jats:italic>\n                      m, and including 70% of 509 patients with triple-negative breast cancer (TNBC) and 50% of 3232 patients with HR+\/HER2-negative eBC. Of 1985 patients tested before a metastatic diagnosis, testing was conducted for 2% before initial diagnosis, for 77% at\/before surgery, and for 21% after definitive surgery; 96 (5%) had\n                      <jats:italic>BRCA<\/jats:italic>\n                      -mutated eBC, including 51 of 1630 (3%) with HR+\/HER2-negative eBC and 45 of 355 (13%) with TNBC. With median follow-up of 20.2 months, 1922 patients (97%) underwent surgery, with greater proportion of patients with\n                      <jats:italic>BRCA<\/jats:italic>\n                      -mutated eBC undergoing mastectomy (83% vs. 32% with no\n                      <jats:italic>BRCA<\/jats:italic>\n                      m). Most patients (&amp;gt;90%) received systemic therapy: 8% neoadjuvant-only, 65% adjuvant-only, and 18% both. Of 49 patients with\n                      <jats:italic>BRCA<\/jats:italic>\n                      -mutated HR+ eBC who had definitive surgery, 36 (73%) received adjuvant therapy, most commonly endocrine therapy-only (20\/36, 59%). Of 44 patients with\n                      <jats:italic>BRCA<\/jats:italic>\n                      -mutated TNBC, 20 (45%) received adjuvant therapy, most commonly immunotherapy (11\/20, 55%). Eighteen patients, all\n                      <jats:italic>BRCA<\/jats:italic>\n                      m tested, received adjuvant olaparib as monotherapy (6 patients) or in a combination regimen (12 patients).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>BRCA<\/jats:italic>\n                      m testing rates in the US remain suboptimal relative to practice guideline recommendations and availability of adjuvant targeted therapy for HER2-negative eBC. Particular areas of unmet need include\n                      <jats:italic>BRCA<\/jats:italic>\n                      m testing for HR+\/HER2-negative eBC, in addition to TNBC, and improving the timeline of\n                      <jats:italic>BRCA<\/jats:italic>\n                      m testing by implementing genetic testing before surgery to inform treatment decisions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1730548","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:52:13Z","timestamp":1772189533000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["BRCA genetic testing and treatment patterns for patients with HER2-negative early-stage breast cancer in the US community setting"],"prefix":"10.3389","volume":"16","author":[{"given":"Kathryn E.","family":"Mishkin","sequence":"first","affiliation":[{"name":"Value & Implementation Outcomes Research, Oncology, Merck & Co., Inc.","place":["Rahway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yezhou","family":"Sun","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Decision Sciences (BARDS), Merck & Co., Inc.","place":["Rahway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Meng","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Decision Sciences (BARDS), Merck & Co., Inc.","place":["Rahway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Xu","sequence":"additional","affiliation":[{"name":"Oncology Outcomes Research, AstraZeneca","place":["Gaithersburg, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qixin","family":"Li","sequence":"additional","affiliation":[{"name":"Oncology Outcomes Research, AstraZeneca","place":["Gaithersburg, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Han","family":"Kao","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Decision Sciences (BARDS), Merck & Co., Inc.","place":["Rahway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagadeswara Rao","family":"Earla","sequence":"additional","affiliation":[{"name":"Value & Implementation Outcomes Research, Oncology, Merck & Co., Inc.","place":["Rahway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M.","family":"Hirshfield","sequence":"additional","affiliation":[{"name":"MRL, Merck & Co., Inc.","place":["Rahway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime A.","family":"Mejia","sequence":"additional","affiliation":[{"name":"MRL, Merck & Co., Inc.","place":["Rahway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.breast.2022.08.010","article-title":"Current and future burden of breast cancer: Global statistics for 2020 and 2040","volume":"66","author":"Arnold","year":"2022","journal-title":"Breast"},{"key":"B2","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1001\/jama.2018.19323","article-title":"Breast cancer treatment: a review","volume":"321","author":"Waks","year":"2019","journal-title":"JAMA"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21863","article-title":"Breast cancer statistics 2024","volume":"74","author":"Giaquinto","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B5","unstructured":"Breast cancer facts & figures 2024-2025"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7112","article-title":"Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers","volume":"317","author":"Kuchenbaecker","year":"2017","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1913948","article-title":"Breast cancer risk genes - 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