Leggett Laura E, Lorenzetti Diane L, Noseworthy Tom, Tiwana Simran, Mackean Gail, Clement Fiona
The Department Community Health Sciences, 3D18, Teaching Research and Wellness Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
Breast Cancer Res Treat. 2014 Apr;144(3):457-65. doi: 10.1007/s10549-014-2900-3. Epub 2014 Mar 5.
Recurrence tests, such as Adjuvant! Online and Oncotype DX, can be used to determine an individual's risk of developing recurrent cancer. These technologies are useful for helping health care practitioners make treatment recommendations. With increasing use, it is necessary to consider patients' experience with and attitudes toward risk of recurrence testing. Factors such as anxiety, influence on decision making, confidence in results, and satisfaction with testing are important to consider. To understand experiences and attitudes toward risk of recurrence testing, from the perspective of women who have used these technologies following a breast cancer diagnosis. A systematic review was completed. Eight multidisciplinary electronic databases, including MEDLINE, PsycINFO, CINAHL, and ERIC, were searched from 1950 to December 17, 2012. Abstracts and full-text papers were screened for inclusion, in duplicate, based on established criteria. Recurrent themes and key concepts were identified and analyzed. One-thousand and twenty-two abstracts were retrieved, and fifty-one proceeded to full-text review. Ten studies reporting on eight populations were included in this review. Key themes that emerged from the literature include: experience with the testing process; influence testing has on treatment; and comprehension of results. The literature suggests that testing for breast cancer recurrence can have a negative impact on women; poor comprehension of test results, and anxiety/distress were the most frequently cited reasons for a negative experience. Despite these drawbacks, women consistently reported that they would recommend testing to others. The literature on this topic is limited, and heterogeneous. The available literature suggests that women are generally satisfied with risk of recurrence testing for breast cancer. Potential drawbacks of risk of recurrence testing include anxiety and comprehension of test results. Additional high-quality research on women's experiences with risk of recurrence testing for breast cancer would improve the evidence base, and would allow stronger conclusions to be drawn.
复发检测工具，如辅助治疗在线工具（Adjuvant! Online）和21基因检测（Oncotype DX），可用于确定个体患复发性癌症的风险。这些技术有助于医疗保健从业者做出治疗建议。随着其使用的增加，有必要考虑患者对复发检测风险的体验和态度。诸如焦虑、对决策的影响、对检测结果的信心以及对检测的满意度等因素都很重要。为了从乳腺癌诊断后使用这些技术的女性的角度了解她们对复发检测风险的体验和态度，我们完成了一项系统综述。检索了包括医学文献数据库（MEDLINE）、心理学文摘数据库（PsycINFO）、护理学与健康领域数据库（CINAHL）和教育资源信息中心数据库（ERIC）在内的8个多学科电子数据库，检索时间跨度为1950年至2012年12月17日。根据既定标准，对摘要和全文论文进行了重复筛选以确定是否纳入。识别并分析了反复出现的主题和关键概念。共检索到1022篇摘要，其中51篇进入全文评审。本综述纳入了10项关于8个群体的研究。文献中出现的关键主题包括：检测过程的体验；检测对治疗的影响；以及对结果的理解。文献表明，乳腺癌复发检测可能会对女性产生负面影响；对检测结果理解不佳以及焦虑/痛苦是负面体验最常被提及的原因。尽管存在这些缺点，但女性一致表示她们会向他人推荐检测。关于这一主题的文献有限且参差不齐。现有文献表明，女性总体上对乳腺癌复发检测风险感到满意。复发检测风险的潜在缺点包括焦虑和对检测结果的理解。关于女性乳腺癌复发检测风险体验的更多高质量研究将改善证据基础，并能得出更有力的结论。
