title: Retention and use of breast cancer recurrence risk information from genomic tests: the role of health literacy.
abstract: BACKGROUND
  New genomic technology now allows physicians to provide women with individualized and highly accurate breast cancer recurrence risk estimates that are a key factor in adjuvant (after surgery) therapy decisions. Because these genomic tests are so new, little is known about how well patients understand the tests and their results.
  
  
  METHODS
  We interviewed 163 stage I or II breast cancer patients at a routine follow-up appointment. We assessed their health literacy (using the Rapid Estimate of Adult Learning in Medicine) as well as their knowledge of and attitudes towards a genomic test that identifies risk of recurrence in hormone receptor-positive, node-negative breast cancer (the OncoType Dx Recurrence Score).
  
  
  RESULTS
  Women with lower health literacy recalled less of the information provided about the recurrence risk test than women with higher health literacy. Health literacy was not related to the amount of additional information women desired. Women with higher health literacy preferred to have a more active role in decisions about the test.
  
  
  CONCLUSIONS
  Health literacy may affect women's capacity to learn about the new genomic tests as well as their desire for informed participation in their medical care.
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Lillie
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: O'Neill
authors.forename: Edward F
authors.initials: EF
authors.lastname: Morrill
authors.forename: E Claire
authors.initials: EC
authors.lastname: Dees
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Carey
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Rimer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology / Q000523:psychology* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003657:Decision Making; D005260:Female; D023281:Genomics; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010353:Patient Education as Topic; D018714:Radiotherapy, Adjuvant; D012044:Regression Analysis; D011795:Surveys and Questionnaires