Identifying hereditary cancer predispositions is vital to providing personalized patient care for patients with breast cancer and their families. Determining who may benefit from genetic counseling and testing is complex. We conducted a retrospective analysis of patients presenting to our breast center to evaluate whether the integration of an on-site genetic counselor improved referral rates and completion of genetic testing for patients at increased genetic risk.

A retrospective review was conducted on patients with newly diagnosed breast center, including assessment of personal and family cancer history. The National Comprehensive Cancer Network (NCCN) Hereditary Breast and Ovarian Cancer guidelines (version 2.2021) were applied to determine which patients met criteria for genetic testing. Chart reviews were also performed to identify whether patients were referred for genetic counseling, and, if so, whether they attended the session.

More than 1400 patient charts were reviewed from 2021 to 2022. In 2021, 70 patients (23.8%) that met NCCN criteria for genetic testing were either missed or not referred; this decreased to 35 (13.6%) missed referrals following the introduction of an on-site genetic counselor (p = 0.002). No significant difference was seen in the number of patients who attended a genetic counseling session (p = 0.832)

The integration of an on-site genetic counselor led to a significant reduction in the proportion of patients who were missed for genetic counseling referrals. This suggests that co-locating genetic counselors within the breast care team improves the identification of at-risk patients and enhances access to genetic counseling, thereby reducing barriers to comprehensive care for patients with newly diagnosed breast cancer.