Please select the eligibility criteria that correspond to the clinical trial below.
Title: Behavioral and Psychosocial Effects of Rapid Genetic Counseling and Testing in Newly Diagnosed Breast Cancer Patients: a Multicenter Study
Brief Summary: 5-10% of breast cancer patients carry a mutation in the BRCA1 or BRCA2 gene. Genetic counseling and DNA testing are usually offered to selected patients after primary treatment has been completed (e.g. the first year after diagnosis). For women with a mutation in one of the two breast-ovarian cancer syndrome genes, chances of a second breast cancer are high, and therefore a proportion of these women may opt for preventive measures in addition to their immediate breast cancer treatment. Contralateral prophylactic mastectomy significantly reduces this risk, and is associated with a reduction in mortality.

Genetic counseling and testing for breast cancer typically takes approximately 4-6 months to complete. However, some hospitals and laboratories are now able to generate test results within 3 to 6 weeks. This technology of rapid genetic testing creates new opportunities for providing both women and their treating surgeons with information potentially relevant for deciding between available treatment options, including type of surgery and adjuvant therapy.

The study will focus on newly diagnosed breast cancer patients who, prior to receiving treatment, are identified as having at least a 10% risk of carrying a mutation in the BRCA1 or BRCA2 genes.

We will investigate whether women with a recent diagnosis of breast cancer make use of rapid genetic counseling when offered.

Furthermore, we will investigate whether the process of genetic counseling (and subsequent DNA testing) has influence on the choice of treatment, and whether and how such rapid genetic counseling and testing (RGCT) affects levels of risk perception, cancer-related worries and distress, and decisional satisfaction.


Options:
A: Inclusion Criteria:

* Male and female inpatients with a diagnosis of schizophrenia/schizoaffective disorder according to ICD 10
* between 18 and 60 years of age are eligible for the study
* informed consent
* inpatients

Exclusion Criteria:

* poor German language skills
B: Inclusion Criteria

1. Over the age of 60
2. The ability to provide informed consent
3. The ability to communicate in English
4. And one of the following:

   1. An established diagnosis of metastatic cancer or
   2. An established diagnosis of advanced heart failure (NYHA class III/IV heart failure) or
   3. An established diagnosis of chronic obstructive lung disease with an FEV1 \< 50% or
   4. Two hospitalizations within the last 6 months or
   5. An advanced illness or multiple comorbidities that are not otherwise specified with an overall prognosis of one year or less confirmed with the attending physician on service. Exclusion Criterion

1. Subject scores 6 or less on the Short Portable Mental Status Questionnaire, which is indicative of cognitive impairment.
C: Inclusion Criteria:

* newly diagnosed breast cancer
* 10% or higher chance of carrying BRCA1/2 gene mutation

Exclusion Criteria:

* age \<18 years
* does not speak Dutch
D: Inclusion Criteria:

Patients

* Women of reproductive age (15-45)
* Wish to discuss starting or changing a contraceptive method during their visit
* Speak, read, and understand English or Spanish (Note: for the pre- and post-intervention audio recording phases, only patients who can speak, read, and understand English easily will be enrolled.)
* History of sexual activity with men

Providers

* Provide contraceptive counseling in one of the participating clinics
* Plan to remain in job role for at least six months

Clinic staff

* Work at one of the participating clinics
* Had a job that included patient contact, but did not solely consist of family planning counseling at the time of the implementation of the intervention

Exclusion Criteria:

Patients

* Previously enrolled in the study
* Previously used the decision support tool at the Women's Community Clinic in San Francisco
* Are unable to get pregnant
* Appointment reason is for insertion of IUD or contraceptive implant
* Currently pregnant
* Desire pregnancy currently or in the next seven months (Note: The last criterion is designed to ensure we will have limited numbers of women that will discontinue their contraceptive methods during the study due to planning a pregnancy.)

Answer: C