Many breast cancer survivors with indications for genetic counseling and testing do not receive it, according to a study published online July 15 in the Journal of Clinical Oncology.

Steven J. Katz, M.D., from the University of Michigan in Ann Arbor, and colleagues examined receipt of genetic testing and communication with relatives about results into survivorship after diagnosis of breast cancer. Analysis included 1,412 women (aged 20 to 79 years) diagnosed with early-stage breast cancer in 2014 or 2015 who completed surveys approximately seven months and six years after diagnosis.

The researchers found that 47.4 percent had indications for genetic testing at any time (28.0 percent at baseline and 19.4 percent at the time of follow-up only). Just over seven in 10 with a baseline indication reported genetic testing (71.9 percent), compared to 53.3 percent with an indication at follow-up only and 35.0 percent with no indication. When controlling for age and clinical indications, there were no significant racial or ethnic differences in receipt of testing or genetic counseling. Women receiving genetic testing with a reported pathogenic variant (62 women) were much more likely to have talked to most or all their first-degree adult relatives about genetic testing, compared to those with a variant of unknown significance (49 women) or a negative finding (419 women; 62.7 percent versus 38.8 and 38.0 percent, respectively).

“Our findings reinforce the need for novel approaches to genetic risk evaluation and testing in practice to target prevention and early detection strategies for their patients and their families,” senior author Allison Kurian, M.D., from Stanford University in California, said in a statement.

Two authors disclosed ties to the biotechnology and pharmaceutical industries.

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