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Hall MJ, Patrick-Miller LJ, Egleston BL, Domchek SM, Daly MB, Ganschow P, Grana G, Olopade OI, Fetzer D, Brandt A, Chambers R, Clark DF, Forman A, Gaber R, Gulden C, Horte J, Long JM, Lucas T, Madaan S, Mattie K, McKenna D, Montgomery S, Nielsen S, Powers J, Rainey K, Rybak C, Savage M, Seelaus C, Stoll J, Stopfer JE, Yao X(S, Bradbury AR. Use and Patient-Reported Outcomes of Clinical Multigene Panel Testing for Cancer Susceptibility in the Multicenter Communication of Genetic Test Results by Telephone Study. JCO Precis Oncol 2018; 2:PO.18.00199. [PMID: 31819920 PMCID: PMC6901130 DOI: 10.1200/po.18.00199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Multigene panels (MGPs) are increasingly being used despite questions regarding their clinical utility and no standard approach to genetic counseling. How frequently genetic providers use MGP testing and how patient-reported outcomes (PROs) differ from targeted testing (eg, BRCA1/2 only) are unknown. METHODS We evaluated use of MGP testing and PROs in participants undergoing cancer genetic testing in the multicenter Communication of Genetic Test Results by Telephone study (ClinicalTrials.gov identifier: ), a randomized study of telephone versus in-person disclosure of genetic test results. PROs included genetic knowledge, general and state anxiety, depression, cancer-specific distress, uncertainty, and satisfaction. Genetic providers offered targeted or MGP testing based on clinical assessment. RESULTS Since the inclusion of MGP testing in 2014, 395 patients (66%) were offered MGP testing. MGP testing increased over time from 57% in 2014 to 66% in 2015 (P = .02) and varied by site (46% to 78%; P < .01). Being offered MGP testing was significantly associated with not having Ashkenazi Jewish ancestry, having a history of cancer, not having a mutation in the family, not having made a treatment decision, and study site. After demographic adjustment, patients offered MGP testing had lower general anxiety (P = .04), state anxiety (P = .03), depression (P = .04), and uncertainty (P = .05) pre-disclosure compared with patients offered targeted testing. State anxiety (P = .05) and cancer-specific distress (P = .05) were lower at disclosure in the MGP group. There was a greater increase in change in uncertainty (P = .04) among patients who underwent MGP testing. CONCLUSION MGP testing was more frequently offered to patients with lower anxiety, depression, and uncertainty and was associated with favorable outcomes, with the exception of a greater increase in uncertainty compared with patients who had targeted testing. Addressing uncertainty may be important as MGP testing is increasingly adopted.
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Affiliation(s)
- Michael J. Hall
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Linda J. Patrick-Miller
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Brian L. Egleston
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Susan M. Domchek
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Mary B. Daly
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Pamela Ganschow
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Generosa Grana
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Olufunmilayo I. Olopade
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Dominique Fetzer
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Amanda Brandt
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Rachelle Chambers
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Dana F. Clark
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Andrea Forman
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Rikki Gaber
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Cassandra Gulden
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Janice Horte
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Jessica M. Long
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Terra Lucas
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Shreshtha Madaan
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Kristin Mattie
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Danielle McKenna
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Susan Montgomery
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Sarah Nielsen
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Jacquelyn Powers
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Kim Rainey
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Christina Rybak
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Michelle Savage
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Christina Seelaus
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Jessica Stoll
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Jill E. Stopfer
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Xinxin (Shirley) Yao
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
| | - Angela R. Bradbury
- Michael J. Hall, Brian L. Egleston, Mary B. Daly, Andrea Forman, Susan Montgomery, Kim Rainey, Christina Rybak, and Michelle Savage, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, Dominique Fetzer, Amanda Brandt, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Jill E. Stopfer, and Angela R. Bradbury, University of Pennsylvania; Susan M. Domchek and Angela R. Bradbury, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Linda J. Patrick-Miller and Olufunmilayo I. Olopade, Center for Clinical Cancer Genetics and Global Health, The University of Chicago; Pamela Ganschow, Rikki Gaber, Terra Lucas, and Christina Seelaus, The John H. Stroger Jr. Hospital of Cook County; Rachelle Chambers, Cassandra Gulden, Shreshtha Madaan, Sarah Nielsen, and Jessica Stoll, The University of Chicago, Chicago, IL; and Generosa Grana, Dana F. Clark, Janice Horte, Kristin Mattie, and Xinxin (Shirley) Yao, MD Anderson Cancer Center at Cooper, Camden, NJ
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