Department of Health Behavior and Health Education, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
Cancer. 2010 Apr 15;116(8):1992-2000. doi: 10.1002/cncr.24990.
Few studies have examined how patients understand and use genomic test results when deciding about treatment. This study examined how women receive and incorporate results of Oncotype DX, a genomic test that offers recurrence risk estimates, into decisions about adjuvant treatment for early stage breast cancer.
Participants in the cross-sectional study were 77 women with early stage, estrogen receptor-positive breast cancer with 0 to 3 positive lymph nodes who received Oncotype DX between 2004 and 2009. Mailed surveys, supplemented by medical chart review, assessed how women received and understood recurrence risk information based on the test.
The most common test results were low (50%, 34 of 68) or intermediate (37%, 25 of 68) breast cancer recurrence risk. Most women accurately recalled their recurrence risk based on the test (71%) and felt they understood much of what they were told about it (67%). Approximately 25% of women recalled experiencing test-related distress. Women's perceived recurrence risk was associated with their actual genomic-based recurrence risks, having had a previous cancer diagnosis, and worry about recurrence. Women with high recurrence risk typically had chemotherapy (78%, 7 of 9), whereas only 2 with a low recurrence risk did (7%, 2 of 30).
This is among the first studies to describe patients' experiences with genomic testing for recurrence risk. Although many women understood discussions about their genomic test results, a third reported not fully understanding these discussions, suggesting a need to aid and improve risk communication and treatment decision making.
很少有研究探讨患者在决定治疗方案时如何理解和使用基因组测试结果。本研究调查了女性如何接收和整合 Oncotype DX 检测结果——一种提供复发风险估计的基因组检测——并将其纳入早期乳腺癌辅助治疗决策。
本横断面研究的参与者为 77 名接受过 2004 年至 2009 年 Oncotype DX 检测的早期雌激素受体阳性乳腺癌伴 0-3 个阳性淋巴结的女性。通过邮寄调查并辅以病历回顾，评估女性根据检测结果接收和理解复发风险信息的情况。
最常见的检测结果为低（50%，68 例中有 34 例）或中（37%，68 例中有 25 例）乳腺癌复发风险。大多数女性根据检测结果准确地回忆起自己的复发风险（71%），并表示她们理解了关于复发风险的大部分信息（67%）。约 25%的女性回忆起经历过与检测相关的困扰。女性感知的复发风险与其实际基于基因组的复发风险、是否有过先前的癌症诊断以及对复发的担忧有关。高复发风险的女性通常接受化疗（78%，9 例中有 7 例），而低复发风险的女性仅有 2 例（7%，30 例中有 2 例）。
这是首批描述患者接受基因组检测用于评估复发风险的研究之一。尽管许多女性理解了关于她们的基因组检测结果的讨论，但三分之一的女性表示并未完全理解这些讨论，这表明需要提供帮助并改进风险沟通和治疗决策。
