Decision regret following rapid genetic testing at the time of breast cancer diagnosis

INTRODUCTION: Genetic testing is increasingly being offered at the time of breast cancer diagnosis to help women guide their treatment decisions. The objective of the current study was to measure decision regret 1 year after genetic testing and to evaluate the factors associated with regret. METHODS: Women from across Canada were referred to receive rapid genetic testing for breast cancer predisposition genes at the time of breast cancer diagnosis (BRCA1, BRCA2, CDH1, PALB2, PTEN, STK11, TP53, ATM, and CHEK2). Questionnaires were completed prior to testing and 1-week and 1-year postgenetic testing. Decision regret was measured at one-year. RESULTS: Overall, 871 women participated and the mean age at diagnosis was 46.0 years (range 19-70 years), and 522 (59.9%) of the women were White. Pathogenic variants were found in 83 women (9.5%). The mean score for decision regret was 7.86 (SD 14.17), with 802 women (92.1%) having no regret and 69 participants (7.9%) having regret. Women from racialized groups were more likely to regret their decision compared to White women (13.4% vs 4.4%; p < .001). Those with a BRCA1 or BRCA2 pathogenic variant were significantly more likely to have regret compared to those with a negative result (p = .03). CONCLUSION: A minority of women who have rapid genetic testing at the time of breast cancer diagnosis later regret their decision. Women at greater risk of having decision regret included those who received a positive BRCA1 or BRCA2 genetic test, and those from racialized groups. Follow-up counseling may be warranted for those who experience decision regret.