Around 5-10% of patients with newly diagnosed breast cancer (PNDBC) are at high risk for second primary breast cancers and ovarian cancer. The reason is because of hereditary breast and ovarian cancer (HBOC) syndrome because of an inherited mutation in BRCA1 or BRCA2.

The study under consideration is based on analysing the timing and outcomes of BRCA testing and definitive surgical treatment among patients with newly diagnosed breast cancer. Materials were mailed around to 3,750 PNDBC between March 2014 and June 2015; 37% (n = 1,381) completed and returned consent form and questionnaire.

From 1209 respondents 54.4% received genetic test results presurgery, 23.2% tested presurgery but received results postsurgery, and 22.3% tested postsurgery. Patients who knew of their mutation-positive results presurgery were more likely to obtain BLM (86.5%) against patients who absorbed that they were mutation-positive post-DST (43.8%).

Besides women with mutation-negative results, participants aware of the results pre- (34.4%) versus post (28.5%) were more likely to choose BLM (OR = 1.32, 95% CI = 1.01 to 1.73, P = .04).

Nearly half of participants did not receive BRCA results presurgery blocking their ability to make positively informed surgical treatment decisions. Women above 50 who test negative are significantly less likely to choose BLM. These results have significant implications for quality of care and costs in the US health system.