Date of Degree

12-2019

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Michael Moon

Advisor

Heather Miles

Abstract

The purpose of this project was to increase adherence to the U.S. Preventive Services Task Force and National Comprehensive Cancer Network guidelines for breast cancer screening and genetic testing.Screening for breast cancer risk factors including genetic testing helps reduce the incidence of breast cancer. A protocol was developed based on national clinical guidelines to increase screening and genetic testing for breast cancer. Provider responsibilities included screening all patients 18 years of age and older for risks factors of breast cancer, referring patients with a significant risk based on the screening for genetic testing and providing referrals for genetic counseling once genetic testing was complete. One hundred fifty-four (47%) of the patients meeting inclusion criteria were screened with 25 (19%) having a positive screen. Fourteen (56%) patients with a positive screen opted for genetic testing, one patient was confirmed having a clinically significant mutation in the BRCA1 gene. One of these patients was identified as having a 35% remaining lifetime breast cancer risk and one patient was identified as having a non-clinically significant mutated gene. Three patients were referred to genetic counseling. One patient followed up with a genetic counselor. Ten (25%) patients meeting genetic testing criteria declined testing. BRCA gene mutations are associated with breast cancer as well as ovarian, melanoma, pancreatic, and prostate cancers. Providers and patients need additional education on the benefits of genetic testing in identifying patients at risk for breast cancer. Early detection and implementation of preventative measures can help reduce morbidity and mortality rates.

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