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Tailored chemotherapy based on tumour gene expression analysis: breast cancer patients' misinterpretations and positive attitudes.

Abstract
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.
AuthorsI Pellegrini, M Rapti, J-M Extra, A Petri-Cal, T Apostolidis, J-M Ferrero, T Bachelot, P Viens, C Julian-Reynier, F Bertucci
JournalEuropean journal of cancer care (Eur J Cancer Care (Engl)) Vol. 21 Issue 2 Pg. 242-50 (Mar 2012) ISSN: 1365-2354 [Electronic] England
PMID22070677 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Copyright© 2011 Blackwell Publishing Ltd.
Chemical References
  • Antineoplastic Agents
Topics
  • Adult
  • Aged
  • Antineoplastic Agents (administration & dosage)
  • Attitude to Health
  • Breast Neoplasms (drug therapy, genetics, psychology)
  • Chemotherapy, Adjuvant
  • Female
  • France
  • Gene Expression Profiling
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Middle Aged
  • Qualitative Research

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