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Comment & Response
December 12, 2018

Guidelines Do Not Proscribe Surgeons Performing Genetic Testing

Author Affiliations
  • 1Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston
  • 2Bermuda Cancer Genetics and Risk Assessment Clinic, Boston, Massachusetts
  • 3TME Breast Care Network, Dallas, Texas
  • 4OasisMD Lifestyle Healthcare, San Diego, California
JAMA Surg. 2019;154(3):269. doi:10.1001/jamasurg.2018.4882

To the Editor The article by Katz and colleagues1 recently published in an issue of JAMA Surgery contains factual errors that are concerning. We would agree that rates of genetic testing are suboptimal, with many patients who should have genetic testing not receiving it, and we also agree that surgeon skill, attitude, and practice factor significantly into this variability. But the problem of suboptimal rates of genetic testing is being exacerbated by examples like Katz and colleagues1 who misinterpret the guidelines as indicating that only genetic counselors can initiate genetic testing. There are far too few genetic counselors to handle the necessary testing, which serves as a major barrier to appropriate testing, as shown by Whitworth et al.2

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