title: Conveying genomic recurrence risk estimates to patients with early-stage breast cancer: oncologist perspectives.
abstract: OBJECTIVE
  The development and increased use of genomic profiling has led to refinement of breast cancer treatment. This study sought to examine medical and surgical oncologists' perceptions of factors related to the translation and integration of Oncotype DX® (Genomic Health, Inc., Redwood City, CA, USA) into routine clinical care.
  
  
  METHODS
  Twenty oncologists (10 medical and 10 surgical oncologists) participated in qualitative interviews. Questions centered on the following themes: oncologists' perceptions about the clinical utility of testing, the impact of patient preferences on the decision to test and use results to inform treatment decisions, methods of communicating risk associated with test results to patients, and benefits of and barriers to incorporating testing into multidisciplinary care settings.
  
  
  RESULTS
  Oncologists found Oncotype DX test results useful in their practice but had concerns as well. These included that some oncologists either used testing inappropriately or placed undue emphasis on the results at the expense of other clinical information. The use of intermediate test results, which have less clear clinical implications, incorporating results with patient treatment preferences, and the use of testing in multidisciplinary teams were noted as specific challenges.
  
  
  CONCLUSIONS
  Oncologists noted several benefits of testing and also many challenges, despite wide dissemination and common use. Education for health providers should include specific training in how to interpret and communicate the uncertainty inherent in genomic tests while integrating patient preferences to inform treatment decision making.
authors: Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA.
authors: Elizabeth
authors: E
authors: Spellman
authors: Nadiyah
authors: N
authors: Sulayman
authors: Susan
authors: S
authors: Eggly
authors: Beth N
authors: BN
authors: Peshkin
authors: Claudine
authors: C
authors: Isaacs
authors: Marc D
authors: MD
authors: Schwartz
authors: Suzanne C
authors: SC
authors: O'Neill
mesh_terms: D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000235:genetics*; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D009364:Neoplasm Recurrence, Local / Q000235:genetics*; D057240:Patient Preference; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012306:Risk; D013043:Specialties, Surgical; D014342:Truth Disclosure
keywords: 21-gene; breast cancer; communication; oncology; physician; qualitative