Department of Medicine, British Columbia Cancer Agency, Vancouver Cancer Centre, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada.
Department of Pediatrics British Columbia Cancer Agency, University of British Columbia, Vancouver, Canada.
Breast Cancer Res Treat. 2018 Feb;168(1):221-228. doi: 10.1007/s10549-017-4586-9. Epub 2017 Nov 27.
The practice of seeking a biopsy to confirm a metastatic relapse of a prior breast cancer is individualized. Tumor samples have well-recognized importance in clinical and translational research, but also an increasing role in routine care. We sought to determine the attitudes of patients and breast cancer clinicians about biopsy at breast cancer relapses.
Consenting breast cancer patients and clinicians completed questionnaires with scenarios of decreasing personal benefit and increasing discomfort or inconvenience associated with biopsy at relapse of a prior breast cancer. For each scenario, patients were asked whether they would, would not, or were unsure about agreeing to a biopsy. Clinicians provided information about their practice, research activities, and usual biopsy habits. They were asked to estimate how often patients would agree to a biopsy under each of the conditions presented to patient participants.
The majority of patients expressed a willingness to undergo a biopsy procedure of modest inconvenience and discomfort to establish an uncertain diagnosis, guide treatment, to participate in a trial, or for research purposes only. About 50% of patients indicated that they would undergo an invasive biopsy procedure requiring IV sedation or general anesthetic for purely altruistic reasons. In spite of being a largely academic group, clinician respondents underestimated patient willingness to have a biopsy in all scenarios, particularly when there was no attached personal benefit.
Breast cancer patients were very willing to undergo biopsy at breast cancer relapse for their routine care, clinical trials, or for research only. Clinicians act as the intermediary between patients and tumor tissue repositories, and clinician perceptions and practices should shift to match the altruistic attitudes of breast cancer patients.
寻求活检以确认先前乳腺癌转移复发的做法是个体化的。肿瘤样本在临床和转化研究中具有公认的重要性，但在常规护理中也发挥着越来越重要的作用。我们旨在确定患者和乳腺癌临床医生对乳腺癌复发时进行活检的态度。
同意参与的乳腺癌患者和临床医生完成了问卷，其中包含与先前乳腺癌复发时活检相关的个人获益减少和不适或不便增加的情况。对于每种情况，患者被问及他们是否会、不会或不确定是否同意进行活检。临床医生提供了关于他们的实践、研究活动和常规活检习惯的信息。他们被要求根据向患者参与者呈现的每种情况估计患者同意进行活检的频率。
大多数患者表示愿意接受适度不便和不适的活检程序，以建立不确定的诊断、指导治疗、参与试验或仅用于研究目的。约 50%的患者表示，他们将接受需要 IV 镇静或全身麻醉的侵入性活检程序，纯粹出于利他主义的原因。尽管临床医生主要是学术群体，但他们在所有情况下都低估了患者进行活检的意愿，尤其是在没有个人获益的情况下。
乳腺癌患者非常愿意在乳腺癌复发时进行活检，以便进行常规护理、临床试验或仅用于研究。临床医生是患者和肿瘤组织库之间的中介，他们的看法和做法应该转变，以符合乳腺癌患者的利他主义态度。
