e22645 Background: Germline genetic testing is important for newly diagnosed breast cancer (BC) patients (pts) as results drive treatment decisions and identification of hereditary cancer risk. In 2023, the National Cancer Institute reported testing rates for people with cancer were still low and a major concern, as testing results can change recommended screening and treatment. In January 2024, ASCO updated guidelines recommending germline testing for all pts 65 years or younger and selected older individuals. At Sylvester Comprehensive Cancer Center (SCCC), part of University of Miami Health System, 45% of newly diagnosed BC pts received genetic testing in 2023. To ensure compliance with updated guidelines, SCCC implemented a targeted initiative to increase germline testing rates by 5% by the end of 2024. Methods: A quality improvement initiative (QII) using a Plan–Do–Study–Act framework was implemented. During the Plan phase breast surgical and medical oncologists were surveyed to identify preferred testing methods and existing testing barriers. The barriers identified included a lack of pre- and post-test counseling patient education materials, guideline awareness, and availability of genetic counselors (GCs). During the Do phase, educational videos and flyers were developed in English and Spanish by a geneticist and GCs. If pts had additional questions, they could schedule an appointment with a GC. A Best Practice Alert (BPA) was also created in the EMR to remind providers to order testing or refer to cancer genetics clinic. Flyers were distributed to all breast surgical and medical oncology clinics. During the Study phase we tracked testing rates and provider feedback. Adjustments to the BPA were made to increase efficacy and decrease burden on providers. During the Act phase, we analyzed testing rates. Results: After implementation of the QII, germline testing completion rose from 45% to 67% in 2024, a 22% increase that exceeded our 5% target. Testing rates were reassessed for the first half of 2025 and found to have increased an additional 14%, a total of 81% of BC pts were now undergoing germline genetic testing. We continue to monitor rates bi-annually to ensure continued adoption and optimization of interventions. Conclusions: This initiative substantially improved genetic testing rates at SCCC, demonstrating the effectiveness of a multifaceted approach, reflective of the needs and workflow of providers. Provider education, patient-facing resources, and electronic decision-support tools worked collectively to reduce barriers, standardize test selection, and enhance adherence to guidelines. The continued increase in testing highlights the sustainability of this approach in routine oncology practice, ultimately leading to more personalized care for pts and families. We hope to apply this strategy to increase rates of genetic testing across all cancer subtypes and improve on rates of cascade testing as well.
Sabin et al. (Thu,) studied this question.