INSERM U912, 232, Aix-Marseille University, Boulevard Ste-Marguerite, Marseille cedex 9, France.
Eur J Cancer Care (Engl). 2012 Mar;21(2):242-50. doi: 10.1111/j.1365-2354.2011.01300.x. Epub 2011 Nov 9.
The aim of this study was to document how breast cancer patients perceive their prognosis and a tailored treatment based on tumour gene expression analysis, and to identify the features of this approach that may impact its clinical application. In-depth interviews were conducted at three French cancer centres with 37 women (35-69 years of age) with node-positive breast cancer undergoing an adjuvant chemotherapy regimen defined on the basis of the genomic signature predicting the outcome after chemotherapy. Several concerns were identified. First, some misconceptions about these methods were identified due to semantic confusions between the terms 'genomic' and 'genetic', which generated anxiety and uncertainty about the future. Second, the 'not done' and 'not interpretable' signatures were misinterpreted by the women and associated with highly negative connotations. However, the use of tumour genomic analysis to adapt the treatment to each patient received most of the patients' approval because it was perceived as an approach facilitating personalised medicine. In conclusion, improving the quality of provider/patient communications should enable patients to play a more active part in the decision making about their treatment. This will ensure that those who agree to have tumour gene analysis have realistic expectations and sound deductions about the final result disclosure process.
本研究旨在记录乳腺癌患者如何感知其预后以及基于肿瘤基因表达分析的个体化治疗，并确定可能影响其临床应用的方法特征。在法国三个癌症中心对 37 名（35-69 岁）接受基于预测化疗后结果的基因组特征定义的辅助化疗方案的淋巴结阳性乳腺癌女性进行了深入访谈。确定了几个关注点。首先，由于“基因组”和“遗传”术语之间的语义混淆，一些对这些方法的误解被发现，从而引起对未来的焦虑和不确定性。其次，女性对“未完成”和“不可解释”的特征进行了错误的解释，并将其与非常负面的含义联系起来。然而，由于认为这种方法有助于实施个体化医学，因此使用肿瘤基因组分析来针对每位患者调整治疗方案得到了大多数患者的认可。总之，提高提供者/患者之间的沟通质量应能使患者在决定治疗方案方面发挥更积极的作用。这将确保那些同意进行肿瘤基因分析的患者对最终结果披露过程有现实的期望和合理的推断。
