Retrospective study of decision regret following rapid genetic testing at the time of breast cancer diagnosis

Genetic testing is increasingly being offered at the time of breast cancer diagnosis to help women guide their treatment decisions. A retrospecive study at the University of Toronto (Canada) investigated decision regret one year after genetic testing and evaluated factors associated with regret. A total of 871 women from across Canada participated. The mean age at diagnosis was 46.0 years (range 19-70); 59.9% were White. They received rapid genetic testing for breast cancer predisposition genes (BRCA1, BRCA2, CDH1, PALB 2, PTEN, STK11, TP53, ATM, and CHEK2). Pathogenic variants were found in 83 women (9.5%). The mean score for decision regret at one year was 7.86 (SD 14.17), with 802 women (92.1%) having no regret and 69 participants (7.9%) having regret. Overall, 94.4% of participants agreed or strongly agreed that ‘I would make the same choice ifI had to do it over again.’ Women from racialized groups were more likely to regret their decision compared to White women (13.4% versus 4.4%; p<0.001). Those with a BRCA1 or BRCA2 pathogenic variant were significantly more likely to have regret compared to those with a negative result (p=0.03). The authors conclude that a minority of women who had rapid genetic testing at the time of breast cancer diagnosis later regret their decision. Follow-up counseling may be warranted for those who experience decision regret.