Publications by authors named "Andrea D Forman"

7 Publications

  • Page 1 of 1

The Hereditary Paraganglioma-Pheochromocytoma Syndrome: No Time to Waste.

JAMA Oncol 2017 12;3(12):1739-1740

Risk Assessment Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania

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http://dx.doi.org/10.1001/jamaoncol.2017.1750DOI Listing
December 2017

The Relevance of Hereditary Cancer Risks to Precision Oncology: What Should Providers Consider When Conducting Tumor Genomic Profiling?

J Natl Compr Canc Netw 2016 06;14(6):795-806

Fox Chase Cancer Center, Philadelphia Pennsylvania

Through tumor genomic profiling (TGP), existing and novel treatments can be selected to better target the specific dysregulated molecular pathways that drive growth and spread of a patient's tumor. Although the primary purpose of TGP is to detect targetable somatic mutations for treatment, TGP may also uncover germline mutations with important implications for patients and family members. Oncology care providers should be aware of the hereditary cancer risks associated with genes commonly tested by TGP. Further, patients should be informed about the possible discovery of hereditary cancer risk information and the relevance of this information to their health and that of family members, and should have their preferences toward further evaluation of hereditary risk information that could be revealed by TGP documented in the medical record and followed.
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http://dx.doi.org/10.6004/jnccn.2016.0080DOI Listing
June 2016

Patient and genetic counselor perceptions of in-person versus telephone genetic counseling for hereditary breast/ovarian cancer.

Fam Cancer 2016 10;15(4):529-39

Department of Oncology, Lombardi Comprehensive Cancer Center, Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.

Telephone genetic counseling (TC) for high-risk women interested in BRCA1/2 testing has been shown to yield positive outcomes comparable to usual care (UC; in-person) genetic counseling. However, little is known about how genetic counselors perceive the delivery of these alternate forms of genetic counseling. As part of a randomized trial of TC versus UC, genetic counselors completed a 5-item genetic counselor process questionnaire (GCQ) assessing key elements of pre-test sessions (information delivery, emotional support, addressing questions and concerns, tailoring of session, and facilitation of decision-making) with the 479 female participants (TC, N = 236; UC, N = 243). The GCQ scores did not differ for TC vs. UC sessions (t (477) = 0.11, p = 0.910). However, multivariate analysis showed that participant race/ethnicity significantly predicted genetic counselor perceptions (β = 0.172, p < 0.001) in that the GCQ scores were lower for minorities in TC and UC. Exploratory analyses suggested that GCQ scores may be associated with patient preference for UC versus TC (t (79) = 2.21, p = 0.030). Additionally, we found that genetic counselor ratings of session effectiveness were generally concordant with patient perceptions of the session. These data indicate that genetic counselors perceive that key components of TC can be delivered as effectively as UC, and that these elements may contribute to specific aspects of patient satisfaction. However, undefined process differences may be present which account for lower counselor perceptions about the effectiveness of their sessions with minority women (i.e., those other than non-Hispanic Whites). We discuss other potential clinical and research implications of our findings.
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http://dx.doi.org/10.1007/s10689-016-9900-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011450PMC
October 2016

Patient Perceptions of Telephone vs. In-Person BRCA1/BRCA2 Genetic Counseling.

J Genet Couns 2016 06 12;25(3):472-82. Epub 2015 Oct 12.

Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.

Telephone genetic counseling (TC) for hereditary breast/ovarian cancer risk has been associated with positive outcomes in high risk women. However, little is known about how patients perceive TC. As part of a randomized trial of TC versus usual care (UC; in-person genetic counseling), we compared high risk women's perceptions of: (1) overall satisfaction with genetic counseling; (2) convenience; (3) attentiveness during the session; (4) counselor effectiveness in providing support; and (5) counselor ability to recognize emotional responses during the session. Among the 554 participants (TC, N = 272; UC, N = 282), delivery mode was not associated with self-reported satisfaction. However, TC participants found counseling significantly more convenient than UC participants (OR = 4.78, 95 % CI = 3.32, 6.89) while also perceiving lower levels of support (OR = 0.56, 95 % CI = 0.40-0.80) and emotional recognition (OR = 0.53, 95 % CI = 0.37-0.76). In exploratory analyses, we found that non-Hispanic white participants reported higher counselor support in UC than in TC (69.4 % vs. 52.8 %; OR = 3.06, 95 % CI = 1.39-6.74), while minority women perceived less support in UC vs. TC (58.3 % vs. 38.7 %; OR = 0.80, 95 % CI = 0.39-1.65). We discuss potential research and practice implications of these findings which may further improve the effectiveness and utilization of TC.
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http://dx.doi.org/10.1007/s10897-015-9897-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4829475PMC
June 2016

Gene panel testing for inherited cancer risk.

J Natl Compr Canc Netw 2014 Sep;12(9):1339-46

From Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Internal Medicine, Division of Human Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio; Clinical and Translational Hereditary Cancer Program, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; and Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania.

Next-generation sequencing technologies have ushered in the capability to assess multiple genes in parallel for genetic alterations that may contribute to inherited risk for cancers in families. Thus, gene panel testing is now an option in the setting of genetic counseling and testing for cancer risk. This article describes the many gene panel testing options clinically available to assess inherited cancer susceptibility, the potential advantages and challenges associated with various types of panels, clinical scenarios in which gene panels may be particularly useful in cancer risk assessment, and testing and counseling considerations. Given the potential issues for patients and their families, gene panel testing for inherited cancer risk is recommended to be offered in conjunction or consultation with an experienced cancer genetic specialist, such as a certified genetic counselor or geneticist, as an integral part of the testing process.
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http://dx.doi.org/10.6004/jnccn.2014.0128DOI Listing
September 2014

Understanding patient and provider perceptions and expectations of genomic medicine.

J Surg Oncol 2015 Jan 3;111(1):9-17. Epub 2014 Jul 3.

Fox Chase Cancer Center, Philadelphia, Pennsylvania.

Advances in genome sequencing technology have fostered a new era of clinical genomic medicine. Genetic counselors, who have begun to support patients undergoing multi-gene panel testing for hereditary cancer risk, will review brief clinical vignettes, and discuss early experiences with clinical genomic testing. Their experiences will frame a discussion about how current testing may challenge patient understanding and expectations toward the evaluation of cancer risk and downstream preventive behaviors.
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http://dx.doi.org/10.1002/jso.23712DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286413PMC
January 2015

Influence of race/ethnicity on genetic counseling and testing for hereditary breast and ovarian cancer.

Breast J 2009 Sep-Oct;15 Suppl 1:S56-62

Familial Risk Assessment Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.

Risk assessment coupled with genetic counseling and testing for the cancer predisposition genes BRCA1 and BRCA2 (BRCA1/2) has become an integral element of comprehensive patient evaluation and cancer risk management in the United States for individuals meeting high-risk criteria for hereditary breast and ovarian cancer (HBOC). For mutation carriers, several options for risk modification have achieved substantial reductions in future cancer risk. However, several recent studies have shown lower rates of BRCA1/2 counseling and testing among minority populations. Here, we explore the role of race/ethnicity in cancer risk assessment, genetic counseling and genetic testing for HBOC and the BRCA1/2 cancer predisposition genes. Barriers to genetic services related to race/ethnicity and underserved populations, including socioeconomic barriers (e.g., time, access, geographic, language/cultural, awareness, cost) and psychosocial barriers (e.g., medical mistrust, perceived disadvantages to genetic services), as well as additional barriers to care once mutation carriers are identified, will be reviewed.
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http://dx.doi.org/10.1111/j.1524-4741.2009.00798.xDOI Listing
December 2009
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