Breast cancer is the most common cancer diagnosis for women and the second leading cause of cancer deaths.1 Many women are not aware of their high-risk status and the steps they could be taking to protect their health, such as more frequent breast screening and utilization of technologies like breast MRI.2,3 Implementing a high-risk screening program can help imaging centers identify high-risk patients and increase screening referrals.
Natera partners with imaging centers to provide a comprehensive suite of NateraCore support services that help integrate the EmpowerTM Hereditary Cancer Test into high-risk breast cancer screening programs.
Where to start with high-risk screening and genetic testing?
For many practices, high-risk screening starts with two steps: gathering a comprehensive family cancer history for each patient and offering genetic testing to patients that meet medical guidelines. Offering these services can help fill a common care gap—1 in 4 women meet the National Comprehensive Cancer Network’s medical guidelines for hereditary cancer testing, but 97% of patients who meet guidelines have not had testing.2,3
Genetic testing for hereditary cancer risk is important to those who want to know more about their risk of developing cancer, why cancer could be common in their family, or who want to be better informed about treatment options following a cancer diagnosis. Obtaining a personal and family medical history helps providers identify which patients are mostly likely to benefit from testing, so as to be able to either order the test or refer the patient to genetic counseling.
Created by leading professional organizations, the National Accreditation Program for Breast Centers (NAPBC) standards support the delivery of high-quality care for breast disease. In addition to its focus on professional education and patient advocacy, NAPBC develops consensus-based, patient-focused standards for breast centers. NAPBC recommends genetic testing and genetic counseling services for patients with family cancer histories that suggest a high risk for breast cancer.
“Identifying patients at increased risk of developing breast and other cancers due to a family history of breast and other cancers or a known hereditary cancer syndrome can have dramatic effects on early detection and cancer outcomes. For this reason, cancer risk assessment and genetic counseling has become the standard of care for patients with a personal and/or family history of breast cancer.“ -NAPBC
What’s involved in a high-risk screening workflow?
While most imaging centers want to provide the best care to their patients, it can be challenging to balance patient needs with the demands placed on staff and doctors. Now, it’s easier than ever to smoothly integrate a high-risk screening program into your existing workflow. Digital programs offer features that will reduce provider strain while delivering high-risk screening:
Automated Health History
Appointment lengths are limited. Working through a health history with a patient during an appointment can take time away from other important conversations and unasked or rushed questions increase the likelihood that a key finding could be overlooked. Traditional screening methods also require extra time and effort to add to a patient’s medical record.
Automated family histories limit these problems, allowing patients to complete their history before their appointment. Some options compare the patient’s responses to current NCCN medical guidelines, automatically flagging high-risk findings for providers to review during the appointment. Some systems integrate with electronic medical records (EMR) to reduce paperwork and to ensure complete records.
Streamlined Patient Education
In the past, it’s been up to providers to learn the ins and outs of a genetic test, to stay up to date on changing medical guidelines, and to help patients work through questions about the process and their results. While nothing will ever replace the importance of the relationship between patients and providers, new tools can make it easier for patients to access information through a reliable source.
Virtual patient education programs provided through an app or website can help educate your patients about testing options so that they’re prepared to have informed conversations with their providers. These programs can help patients to learn about testing options and their test test results. The programs can also help patients connect with genetic counseling services when they have questions.
Integrated Software Systems
Complicated ordering for genetic testing and genetic counseling referrals can result in decreased screening options for high-risk patients. In addition to automating record keeping, many screening services have digital options to reduce paperwork across the board. Imaging center providers can order testing within their existing risk management system (RMS), and findings can automatically be delivered both to the RMS and patients.
Natera delivers custom high-risk screening for imaging centers
With NateraCore’s integrated digital tools and support services, it’s easier than ever to get started with the Empower hereditary cancer test. Using blood or saliva samples Empower offers 5 curated gene panels to test up to 81 genes associated with risk for common hereditary cancers. To inform breast cancer treatment decisions, Empower also offers a Breast STAT panel that can deliver results in 5-7 days. With custom family history screening tools, and orders that can be placed from your existing mammography software system, Natera makes it easy to identify those at risk for breast cancer. Natera offers access to educational tools for patients about genetic screening and access to readily available board-certified genetic counselors.
Streamline Personal and Family Health Screening
Before your patient’s appointment, Natera offers custom screening tools to help you to collect patient health history from your office or at home,. Natera’s Educational Virtual Assistant (NEVA) collects a complete personal and family health history, and provides education about the Empower test, all before the appointment. With NEVA, the initial screening process is automated and findings are automatically added to the Electronic Medical Record (EMR). Volpara health risk pathways or PenRad Genetic Risk Management System customers are notified when patients meet medical guidelines for hereditary cancer testing.
Integrate to Existing Systems
With NateraCore’s quick start support for rapid software integration, data seamlessly integrates with existing software and EMR to provide complete medical records. Empower tests can be ordered directly through your center’s integrated EMR or Radiology Information System (RIS), or online through the NateraConnect online provider portal. Without printing a single page, providers can order kits, access real-time order status, view patient results, share reports with patients, and receive guided workflow recommendations1.
Receive Clear and Actionable Results
The Empower test will return one of three results (negative, positive, or variant of uncertain significance), along with actionable recommendations based on medical guidelines. For women without genetic breast cancer risk, Empower also provides a Tyrer-Cuzick score, in addition to any genetic findings for other types of cancer. A Tyrer-Cuzick score provides value to those without a breast cancer-related gene mutation who could still be at increased risk for breast cancer based on their family cancer history and lifetime estrogen exposure.
Offer Accessible Genetic Counseling
Natera’s Certified Genetic Counselors are available to provide support throughout the process—before the test is ordered, while samples are being processed, and after results are delivered. Individuals can schedule complimentary sessions at any time to learn more about Empower or to help them understand results. Additional information about Natera’s Genetic Information Sessions is available here.
Natera makes it easy to screen and test, integrate data, monitor progress, offer genetic counseling and meet national standards. Follow these links to learn more about adding Empower to an existing breast cancer screening program or read about goal setting for high-risk breast care programs.
1https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm. Accessed December 2021.
2Couch FJ, Shimelis H, Hu C, et al. Associations Between Cancer Predisposition Testing Panel Genes and Breast Cancer. JAMA Oncol. 2017;3(9):1190-1196. doi:10.1001/jamaoncol.2017.0424
3DeFrancesco M. et al. 2018. Hereditary Cancer Risk Assessment and Genetic Testing in the Community-Practice Setting. Obstet Gynecol. 132(5):1121-1129