Women's experiences with genomic testing for breast cancer recurrence risk.
BACKGROUND
Few studies have examined how patients understand and use genomic test results when deciding about treatment. This study examined how women receive and incorporate results of Oncotype DX, a genomic test that offers recurrence risk estimates, into decisions about adjuvant treatment for early stage breast cancer.


METHODS
Participants in the cross-sectional study were 77 women with early stage, estrogen receptor-positive breast cancer with 0 to 3 positive lymph nodes who received Oncotype DX between 2004 and 2009. Mailed surveys, supplemented by medical chart review, assessed how women received and understood recurrence risk information based on the test.


RESULTS
The most common test results were low (50%, 34 of 68) or intermediate (37%, 25 of 68) breast cancer recurrence risk. Most women accurately recalled their recurrence risk based on the test (71%) and felt they understood much of what they were told about it (67%). Approximately 25% of women recalled experiencing test-related distress. Women's perceived recurrence risk was associated with their actual genomic-based recurrence risks, having had a previous cancer diagnosis, and worry about recurrence. Women with high recurrence risk typically had chemotherapy (78%, 7 of 9), whereas only 2 with a low recurrence risk did (7%, 2 of 30).


CONCLUSIONS
This is among the first studies to describe patients' experiences with genomic testing for recurrence risk. Although many women understood discussions about their genomic test results, a third reported not fully understanding these discussions, suggesting a need to aid and improve risk communication and treatment decision making.
Tzeng
Janice P
JP
Department of Health Behavior and Health Education, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
Mayer
Deborah
D
Richman
Alice R
AR
Lipkus
Isaac
I
Han
Paul K
PK
Valle
Carmina G
CG
Carey
Lisa A
LA
Brewer
Noel T
NT
D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003142:Communication; D003657:Decision Making; D005260:Female; D005820:Genetic Testing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D012008:Recurrence; D012306:Risk; D018570:Risk Assessment