Published in:
Open Access
01-07-2020 | Breast Cancer | Clinical trial
Patients’ perceptions of 70-gene signature testing: commonly changing the initial inclination to undergo or forego chemotherapy and reducing decisional conflict
Authors:
Julia E. C. van Steenhoven, Bianca M. den Dekker, Anne Kuijer, Paul J. van Diest, Peter Nieboer, Johanna M. Zuetenhorst, Alex L. Th. Imholz, Sabine Siesling, Thijs van Dalen
Published in:
Breast Cancer Research and Treatment
|
Issue 1/2020
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Abstract
Purpose
Little is known about the impact of 70-gene signature (70-GS) use on patients’ chemotherapy decision-making. The primary aim of this study was to evaluate the impact of 70-GS use on patients’ decisions to undergo chemotherapy. The perceived decision conflict during decision-making was a secondary objective of the study.
Methods
Patients operated for estrogen receptor positive early breast cancer were asked to fill out a questionnaire probing their inclination to undergo chemotherapy before deployment of the 70-GS test. After disclosure of the 70-GS result patients were asked about their decision regarding chemotherapy. Patients’ decisional conflict was measured using the 16-item decisional conflict scale (DCS); scores < 25 are associated with a persuaded decision while a score > 37.5 implies that one feels unsure about a choice.
Results
Between January 1th 2017 and December 31th 2018, 106 patients completed both questionnaires. Before deployment of the 70-GS, 58% of patients (n = 62) formulated a clear treatment preference, of whom 21 patients (34%) changed their opinion on treatment with chemotherapy following the 70-GS. The final decision regarding chemotherapy was in line with the 70-GS result in 90% of patients. The percentage of patients who felt unsure about their preference to be treated with chemotherapy decreased from 42 to 5% after disclosure of the 70-GS. The mean total DCS significantly decreased from pre-test to post-test from 35 to 23, irrespective of the risk estimate (p < 0.001).
Conclusion
Deployment of the 70-GS changed patients’ inclination to undergo adjuvant chemotherapy in one third of patients and decreased patients’ decisional conflict.