[The Impact of Early Preoperative BRCA Genomic Test on Surgical Decision Making and the Importance of Medical Care Team].

OBJECTIVE

To evaluate the impact of a rapid testing workflow for obtaining BRCA genomic test results prior to surgery and multidisciplinary collaboration on surgical treatment selection.

METHODS

Among 190 breast cancer patients who underwent BRCA genomic test from January 2021 to December 2023, 161 cases were analyzed after excluding cases with missing data and those undergoing companion diagnostic testing. The study period was divided into an early phase(35 cases)and a late phase(61 cases), and a retrospective comparison was conducted to evaluate the timing of testing, the duration from initial presentation to surgery, and surgical procedure selection.

RESULTS

The preoperative testing rate increased from 45.5% to 72.6%, and the average number of days from initial visit to test results decreased from 24.4 days to 15.9 days. Among the 16 BRCA-positive patients, 87.5% chose mastectomy(including 25% contralateral prophylactic mastectomy), and 79.1% of the 43 BRCA-negative patients eligible for breast-conserving surgery opted for breast-conserving surgery.

CONCLUSION

A rapid diagnostic workflow and multidisciplinary collaboration are effective strategies for providing genetic information preoperatively and enabling personalized surgical treatment.