E-Mail karger@karger.com Review Public Health Genomics 2014;17:190–208 DOI: 10.1159/000362358 Medical Genetic Counseling for Breast Cancer in Primary Care: A Synthesis of Major Determinants of Physicians’ Practices in Primary Care Settings Jalila Jbilou   a, b Norrin Halilem   c Jolyane Blouin-Bougie   c Nabil Amara   c Réjean Landry   c Jacques Simard   d a  Centre de formation médicale du Nouveau-Brunswick, b  School of Psychology, Université de Moncton, Moncton, N.B., and c  Department of Management and d  Cancer Genomics Laboratory, Department of Molecular Medicine, Laval University, Quebec, Qué., Canada BC in primary care medical practices and routines. However, our results shed light on 2 levels of actions that could im- prove genetic counseling services in primary care: (1) medi- cal training and educational efforts emphasizing family his- tory collection (individual level), and (2) clarification of roles and responsibilities in ordering and referral practices in ge- netic counseling and genetic testing for better healthcare management (organizational level). © 2014 S. Karger AG, Basel Introduction Breast cancer is the most frequently diagnosed cancer among women (23% of all cancers) and the leading cause of cancer mortality among women worldwide [1]. A woman in the developed world has a lifetime risk of de- veloping breast cancer of approximately 9–11% [2]. The estimated global economic burden of new breast cancer cases in 2009 was USD 28 billion, representing associated medical costs as the largest fraction (46%), followed by productivity losses (27%), and non-medical service costs (27%) [3]. Genetic research identified pathogenic muta- tions in BRCA1 and BRCA2 genes in 5–10% of hereditary Key Words Breast cancer · Genetic risk communication · Genetic risk prediction · Medical behavior · Medical genetic counseling · Primary care · Scoping review Abstract Objectives: This paper aims to identify relevant potential predictors of medical genetic counseling for breast cancer (MGC-BC) in primary care and to develop a comprehensive questionnaire to study MGC-BC. Methods: A scoping review was conducted to identify the predictors of MGC-BC among primary care physicians. Relevant articles were identified in selected databases (PubMed, Embase, CINAHL, ISI Web of Science, PsycINFO, and Cochrane CENTRAL) and 4 selected relevant electronic journals. Results: An inductive analysis of the 193 quantitatively tested variables, conducted by 3 re- searchers, showed that 6 conceptual categories of determi- nants, namely (1) demographic, (2) organizational, (3) expe- riential, (4) professional, (5) psychological, and (6) cognitive, influence MGC-BC practices. Conclusion: There is a scarcity of literature addressing the medical behavior determinants of MGC-BC. Future research is needed to identify effective strategies put into action to support the integration of MGC- Received: November 11, 2013 Accepted after revision: March 20, 2014 Published online: July 3, 2014 Nabil Amara Université Laval 2325, Rue de la Terrasse Québec, QC G1V 0A6 (Canada) E-Mail nabil.amara  @  mng.ulaval.ca © 2014 S. Karger AG, Basel 1662–4246/14/0174–0190$39.50/0 www.karger.com/phg