title: Metastatic breast cancer patients: attitudes toward tissue donation for rapid autopsy.
abstract: Rapid autopsy (RA) offers a unique opportunity to obtain a large amount of metastatic tissue at death in order to deepen existing understanding of cancer evolution and heterogeneity. In breast cancer, understanding metastasis is particularly valuable given that treatment regimens are based on the traditional hormone and HER2 receptor status as well as evolving genomic data of the primary tumor. We aimed to elucidate the attitudes and interests of patients with metastatic breast cancer (MBC) toward RA, and to identify associated demographic or disease characteristics that may influence patient attitudes and interest. Ninety-seven patients with MBC were surveyed over the course of 12 months at a large, urban comprehensive cancer center's breast cancer outpatient clinic. 93/97 patients completed the survey sufficiently to be included in the analysis. Fisher's exact test was employed for categorical variables, and t test and rank-sum tests for continuous variables. p values ≤0.05 were considered statistically significant. Of the 93 patients with MBC analyzed, 87 % were willing to donate tissue at death. Marital status and younger age were associated with willingness to donate (p = 0.000, p = 0.025, respectively). Race, employment status, religion/spirituality, and cancer subtype were not associated with likelihood of donating. Forty-five percent of patients felt that doctors should ask about RA at diagnosis of early-stage breast cancer rather than during late-stage disease. These data provide evidence that an RA program would be welcomed by patients and requires initiative by providers.
authors.affiliation: Department of Internal Medicine, University of Pittsburgh Medical Center, Montefiore Hospital N-715, 200 Lothrop Street, Pittsburgh, PA, 15213, USA. achkart@upmc.edu.
authors.forename: Tala
authors.initials: T
authors.lastname: Achkar
authors.affiliation: Department of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
authors.forename: John
authors.initials: J
authors.lastname: Wilson
authors.affiliation: Division of Hematology/Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center (UPMC), 300 Halket Street, Pittsburgh, PA, 15213, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Simon
authors.affiliation: Division of Hematology/Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center (UPMC), 300 Halket Street, Pittsburgh, PA, 15213, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Rosenzweig
authors.affiliation: Division of Hematology/Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center (UPMC), 300 Halket Street, Pittsburgh, PA, 15213, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Puhalla
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement
keywords: Metastatic breast cancer; Rapid autopsy; Rapid tissue donation; Tissue donation