Abstract P2-11-02: Managing breast and ovarian cancer risk: A novel approach to teaching residents comprehensive risk reduction and management strategies
Authors: Lindner Deborah S 
Published: May 2015

Introduction: Awareness about genetic predisposition to breast and ovarian cancer and access to genetic testing has increased dramatically over the last decade, particularly with the increase in direct to consumer marketing of genetic testing. While professional organizations have published bulletins addressing this topic, a working knowledge of how to identify and manage high risk patients is lacking among many physicians. The goal of this pilot study was to assess knowledge deficits in breast and ovarian cancer risk assessment and management among primary care residents and to determine whether a novel approach to teaching this subject will help bridge the perceived knowledge gap.

Methods: A novel case based learning module was developed by a multidisciplinary team of Breast Surgeons, Gynecologic Oncologists, Obstetrician/Gynecologists, Psychologists and Genetic Counselors as a practical approach to assessing risk level based on personal and family history and applying standard recommendations for screening and risk reduction. This approach is unique, as lectures in an academic setting often focus on management of high risk patients, but not on risk stratification and risk reduction in all comers. Surveys were completed by residents after the workshop to assess perceived knowledge before and after the presentation.

Results: 106 residents from Internal Medicine, Obstetrics and Gynecology and Family Medicine residency programs were surveyed after participating in the lecture and case based learning module. 87 (82%) responded that the information presented was new to them. 101 (95%) responded that the training increased their knowledge about the options available to young women for risk reduction and early detection of breast and ovarian cancer. 105 (99%) responded that after attending the training, they understood how to identify patients that are at an increased risk for developing breast and ovarian cancer and should be referred for genetic counseling and testing. 100 (94%) indicated they would incorporate material in the training into their everyday practice.

Discussion: Resident surveys confirmed there is a knowledge gap among trainees in breast and ovarian cancer risk assessment and management. While professional organizations have created guidelines for patient management, most trainees are either unaware of recommendations, or feel the information is not being presented in a way that allows them to use it practically in patient management. The novel educational workshop presented here increased perceived knowledge among residents, allowed them to correctly identify high risk patients, and increased their working knowledge of risk reduction strategies among high and low risk patients. Recent studies have demonstrated poor coordination of care and lack of followup for the majority of high risk patients who do not opt for risk reducing surgery within the first few months after diagnosis of a gene mutation. The need for more comprehensive education among emerging medical professionals in this area is clear. Using a practical, risk stratification approach to identify and manage high risk patients is successful in bridging the knowledge gap among residents in primary care specialties.

Citation Format: Deborah S Lindner. Managing breast and ovarian cancer risk: A novel approach to teaching residents comprehensive risk reduction and management strategies [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-11-02.