Surgical oncologist David Euhus explains how and when genetic testing for patients with breast cancer performed at Johns Hopkins, how this process has been streamlined to get results faster and shares how genetic testing will look like in the future.
mm hmm. Okay. Yeah. So as people have become more familiar with what genetic testing is, as the federal government has implemented laws that um, prevent genetic discrimination. And as we've learned more about patients who get genetic testing, we realize that it's it's really not as complicated as it seemed when it first started. And as it needed to be when it first started. Uh, so we've taken the actual testing out of the specialized cancer genetics center and put it into the breast surgery clinics. So a new breast cancer patients seen in any one of our johns Hopkins clinics will have the option of getting genetic testing done right there. As the technology has improved, it's gone from a blood draw to a simple spit test. Um, it smelled in and we get the results on the first seven jeans, usually within about a week instead of waiting six weeks. So suddenly we're in a position where we can have the information to calculate risk of second breast cancers. We can understand whether certain drugs are gonna be helpful for certain patients very rapidly. And as part of the new patient evaluation. Okay. Yeah. So we worked with the cancer genetics specialists to set up a plan where we could test patients in the surgery clinics when they come in for their initial appointment. So the cancer genetic counselors, there are very busy people. They're very skilled and knowledgeable people and they really didn't need to be spending time sorting through patients to figure out who needs testing, who doesn't need testing. So now the surgeons are getting the testing done in the surgery clinic. And when there's a mutation, they go to the cancer genetics professionals to understand the risk of other cancers. And to get referrals set up with other specialists that can help manage those risks. Mm hmm. And it's wonderful that we can get these genetic test results and understand better what types of surgery to do, understand whether we can do radiation treatments, understand what types of systemic treatments we need to do. But the thing is people with these inherited predispositions with these genetic um mutations that they've inherited their high risk for breast cancer. And in a way it's a bit of a failure if we don't find out about their mutation until after they're diagnosed with breast cancer. Because there's many things they can do. You know, we'll start MRI's at age 25 if we know you have a B. R. C. A. One mutation and some women opt for prophylactic surgery and then they just never even get the cancers. So in the future, genetic testing is going to become more widely available to anybody who wants. It essentially is concerned about their genetic risk and would be willing to take measures to address that risk and maybe avoid the cancer's altogether. Mm hmm. Okay. Yeah.