Achkar Tala, Wilson John, Simon Jacqueline, Rosenzweig Margaret, Puhalla Shannon
Department of Internal Medicine, University of Pittsburgh Medical Center, Montefiore Hospital N-715, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.
Department of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
Breast Cancer Res Treat. 2016 Jan;155(1):159-64. doi: 10.1007/s10549-015-3664-0. Epub 2015 Dec 24.
Rapid autopsy (RA) offers a unique opportunity to obtain a large amount of metastatic tissue at death in order to deepen existing understanding of cancer evolution and heterogeneity. In breast cancer, understanding metastasis is particularly valuable given that treatment regimens are based on the traditional hormone and HER2 receptor status as well as evolving genomic data of the primary tumor. We aimed to elucidate the attitudes and interests of patients with metastatic breast cancer (MBC) toward RA, and to identify associated demographic or disease characteristics that may influence patient attitudes and interest. Ninety-seven patients with MBC were surveyed over the course of 12 months at a large, urban comprehensive cancer center's breast cancer outpatient clinic. 93/97 patients completed the survey sufficiently to be included in the analysis. Fisher's exact test was employed for categorical variables, and t test and rank-sum tests for continuous variables. p values ≤0.05 were considered statistically significant. Of the 93 patients with MBC analyzed, 87 % were willing to donate tissue at death. Marital status and younger age were associated with willingness to donate (p = 0.000, p = 0.025, respectively). Race, employment status, religion/spirituality, and cancer subtype were not associated with likelihood of donating. Forty-five percent of patients felt that doctors should ask about RA at diagnosis of early-stage breast cancer rather than during late-stage disease. These data provide evidence that an RA program would be welcomed by patients and requires initiative by providers.
快速尸检（RA）提供了一个独特的机会，即在死亡时获取大量转移组织，以加深对癌症演变和异质性的现有认识。在乳腺癌中，鉴于治疗方案基于传统的激素和HER2受体状态以及原发性肿瘤不断发展的基因组数据，了解转移情况尤为重要。我们旨在阐明转移性乳腺癌（MBC）患者对快速尸检的态度和兴趣，并确定可能影响患者态度和兴趣的相关人口统计学或疾病特征。在一家大型城市综合癌症中心的乳腺癌门诊，对97例MBC患者进行了为期12个月的调查。97例患者中有93例完成了足够的调查，可纳入分析。分类变量采用Fisher精确检验，连续变量采用t检验和秩和检验。p值≤0.05被认为具有统计学意义。在分析的93例MBC患者中，87%愿意在死亡时捐赠组织。婚姻状况和较年轻的年龄与捐赠意愿相关（分别为p = 0.000，p = 0.025）。种族、就业状况、宗教/精神信仰和癌症亚型与捐赠可能性无关。45%的患者认为医生应该在早期乳腺癌诊断时而非晚期疾病时询问快速尸检的情况。这些数据表明，快速尸检项目会受到患者欢迎，且需要医疗服务提供者积极推动。
