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5 times more likely to be present in notes of high- compared to moderate-risk genes (OR=2.53, 95% CI 1.71-3.8, and when summary notes indicated the presence of a friend or relative (OR=2.29, 95% CI 1.50-3.48). Summary notes frequently attempted to contextualize the patients' familial relationships by referencing positive family communication patterns (41.6%) or negative communication issues (2.4%) and included various strategies to address barriers to communication and assist relatives with cascade testing. Overall, GCs consistently do

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