Trial Information

Methods in Education for Breast Cancer Genetics

In October 1995 the National Naval Medical Center opened the only Department of Defense
funded Breast Care Center (BCC). Within less than one year the Center was seeing 100 - 200
new patients per week and making 10 - 20 new diagnoses of breast cancer per month. In 1997
we began conducting germline testing for BRCA1 and BRCA2 under an approved Navy IRB study.
To date, 51 individuals have enrolled into the Education and Counseling component, and 42
individuals have elected to receive germline testing. Early on it became apparent that a
more time efficient approach to education and counseling would be required if access to
information on breast cancer genetics was to be made available to a larger population.
Traditionally, education and counseling has been offered on a one to one basis prior to
germline testing. Often, hours are spent with an individual. At some centers, multiple
visits are standard. Not only is there a shortage of health care providers trained in
cancer genetics, but even if there were an abundance of trained providers, the time and
cost, as well as need for efficiency would preclude this type of approach. Thus, this
approach is not applicable to most health care delivery systems. We began offering
education in small groups approximately 18 months ago, using the same informational content
that we use in our one to one sessions. Based on preliminary, nonrandomized results, there
appeared to be no difference in learning and general patient satisfaction based on results
of pre- and post-test administered before and after the education. It was our contention
that group education is equivalent, and in some situations better than individual education.
Therefore, we will conduct a randomized trial designed to test equivalence between
individual and group education.