Educational needs in genetic medicine: primary care perspectives.

BACKGROUND/AIMS: This study was performed to identify primary care physicians' (PCPs) attitudes toward genetic medicine and their perceived needs for education in this area. METHODS: Semistructured telephone interviews with 24 PCPs in the northwestern United States. RESULTS: PCPs are interested in learning more about who should receive genetic testing and what tests are available. Training in counseling and risk communication is desired, as are 'just-in-time' resources to guide clinical decisions. CONCLUSIONS: PCPs are eager to learn about genetic medicine; however, their priorities may differ in emphasis from those put forward by genetics experts. Future educational efforts would do well to build on PCPs' prior knowledge base, highlight the clinical relevance of genetic medicine to primary care practice, and emphasize 'red flags': cues to alert PCPs to a potential genetic contribution.

Varying levels of family history of breast cancer in relation to mammographic breast density (United States).

OBJECTIVE: We examined the relationship between breast cancer family history and mammographic breast density. METHODS: Participants included 35,019 postmenopausal women aged >or=40 years enrolled in a population-based mammography screening program. We collected data on the number and type of 1st and 2nd degree female relatives with a history of breast cancer and their ages at diagnosis. We used the Breast Imaging Reporting and Data System breast density categories to identify women with fatty (1 = almost entirely fatty or 2 = scattered fibroglandular tissue) and dense (3 = heterogeneously dense or 4 = extremely dense) breasts. We used logistic regression to calculate odds ratios (OR) and 95% confidence intervals for dense (N = 18,111) compared to fatty breasts (N = 16,908). RESULTS: The odds of having dense breasts were 17% greater for women with affected 1st degree relatives than women with no family history. The odds increased with more affected 1st degree relatives [>or=3 vs. none (OR = 1.46; 1.05-2.01)] and among women with >or=1 affected 1st degree relative diagnosed <50 years (OR = 1.22; 1.10-1.34). CONCLUSIONS: Having a family history of breast cancer was more strongly associated with mammographic breast density when the affected relatives were more genetically similar. There may be common, yet undiscovered, genetic elements that affect breast cancer and mammographic breast density.