{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:10:48Z","timestamp":1791486648217,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,2]],"date-time":"2023-04-02T00:00:00Z","timestamp":1680393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001006","name":"Breast Cancer Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001026","name":"National Breast Cancer Foundation","doi-asserted-by":"publisher","award":["IIRS\u201020\u2010080"],"award-info":[{"award-number":["IIRS\u201020\u2010080"]}],"id":[{"id":"10.13039\/501100001026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1153049"],"award-info":[{"award-number":["1153049"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1175960"],"award-info":[{"award-number":["1175960"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the feasibility of universal genetic testing of women with newly diagnosed breast cancer, to estimate the incidence of pathogenic gene variants and their impact on patient management, and to evaluate patient and clinician acceptance of universal testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants<\/jats:title>\n                    <jats:p>\n                      Prospective study of women with invasive or high grade\n                      <jats:italic>in situ<\/jats:italic>\n                      breast cancer and unknown germline status discussed at the Parkville Breast Service (Melbourne) multidisciplinary team meeting. Women were recruited to the pilot (12 June 2020 \u2013 22 March 2021) and expansion phases (17 October 2021 \u2013 8 November 2022) of the Mutational Assessment of newly diagnosed breast cancer using Germline and tumour genomICs (MAGIC) study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Germline testing by DNA sequencing, filtered for nineteen hereditary breast and ovarian cancer genes that could be classified as actionable; only pathogenic variants were reported. Surveys before and after genetic testing assessed pilot phase participants\u2019 perceptions of genetic testing, and psychological distress and cancer\u2010specific worry. A separate survey assessed clinicians\u2019 views on universal testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pathogenic germline variants were identified in 31 of 474 expanded study phase participants (6.5%), including 28 of 429 women with invasive breast cancer (6.5%). Eighteen of the 31 did not meet current genetic testing eligibility guidelines (probability of a germline pathogenic variant \u2265\u200910%, based on CanRisk, or Manchester score\u2009\u2265\u200915). Clinical management was changed for 24 of 31 women after identification of a pathogenic variant. Including 68 further women who underwent genetic testing outside the study, 44 of 542 women carried pathogenic variants (8.1%). Acceptance of universal testing was high among both patients (90 of 103, 87%) and clinicians; no decision regret or adverse impact on psychological distress or cancer\u2010specific worry were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Universal genetic testing following the diagnosis of breast cancer detects clinically significant germline pathogenic variants that might otherwise be missed because of testing guidelines. Routine testing and reporting of pathogenic variants is feasible and acceptable for both patients and clinicians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.51906","type":"journal-article","created":{"date-parts":[[2023,4,2]],"date-time":"2023-04-02T20:19:17Z","timestamp":1680466757000},"page":"368-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Universal genetic testing for women with newly diagnosed breast cancer in the context of multidisciplinary team care"],"prefix":"10.5694","volume":"218","author":[{"given":"Dilanka L","family":"De Silva","sequence":"first","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"Parkville Familial Cancer Centre Peter MacCallum Cancer Centre and Royal Melbourne Hospital  Melbourne VIC"},{"name":"Memorial Sloan Kettering Cancer Center  New York NY United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Stafford","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"The Royal Melbourne Hospital  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita R","family":"Skandarajah","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"The Royal Melbourne Hospital  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Royal Women's Hospital  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Devereux","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"Peter MacCallum Cancer Centre  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Hogg","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maira","family":"Kentwell","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"Parkville Familial Cancer Centre Peter MacCallum Cancer Centre and Royal Melbourne Hospital  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Park","sequence":"additional","affiliation":[{"name":"The Royal Melbourne Hospital  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luxi","family":"Lal","sequence":"additional","affiliation":[{"name":"The Royal Melbourne Hospital  Melbourne VIC"},{"name":"Peter MacCallum Cancer Centre  Melbourne VIC"},{"name":"Walter and Eliza Hall Institute of Medical Research  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Zethoven","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madawa W","family":"Jayawardana","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"Peter MacCallum Cancer Centre  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Chan","sequence":"additional","affiliation":[{"name":"The Royal Children's Hospital Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis N","family":"Butow","sequence":"additional","affiliation":[{"name":"Centre for Medical Psychology and Evidence\u2010based Decision Making, the University of Sydney  Sydney NSW"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A","family":"James","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"Parkville Familial Cancer Centre Peter MacCallum Cancer Centre and Royal Melbourne Hospital  Melbourne VIC"},{"name":"The Royal Melbourne Hospital  Melbourne VIC"},{"name":"Peter MacCallum Cancer Centre  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G Bruce","family":"Mann","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"The Royal Melbourne Hospital  Melbourne VIC"},{"name":"Royal Women's Hospital  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian G","family":"Campbell","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne VIC"},{"name":"Peter MacCallum Cancer Centre  Melbourne 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