Study on the differences of opinions and choices of high-risk breast cancer populations in China before and after genetic testing

Background: In recent years, genetic testing (GT) has developed rapidly in China. However, the cancer genetic service system is still immature in China. Little is known about the opinions around genetic counseling (GC) and GT in Chinese individuals at high risk of breast cancer. This work aims to understand the changes in awareness, attitudes, and willingness of high-risk populations before and after GT, as well as the possible barriers to GC/GT. Methods: Several questionnaires for the high-risk populations of breast cancer were completed. Then, some patients were selected for free single/multi-gene testing as well as further survey and statistical analysis. Results: Despite low levels of awareness, Chinese high-risk breast cancer groups hold positive attitudes about GC/GT. There were differences in the willingness of different groups of high-risk people. After GT, different testing results led to different views and choices for the patients than before GT. Lack of genetic knowledge of breast cancer, misunderstanding, cost, fear of adverse effects, and policy market factors are obstacles to accepting GC/GT for the participants. Conclusions: Chinese doctors need to communicate according to the specific situation of high-risk individuals in pre-test counseling and post-test counseling. The national policy and GT market also need to be improved to support the hereditary breast cancer families' follow-up service system.