The value of personalizing medicine: medical oncologists' views on gene expression profiling in breast cancer treatment

The Oncologist
Y BombardD A Marshall

Abstract

Guidelines recommend gene-expression profiling (GEP) tests to identify early-stage breast cancer patients who may benefit from chemotherapy. However, variation exists in oncologists' use of GEP. We explored medical oncologists' views of GEP tests and factors impacting its use in clinical practice. We used a qualitative design, comprising telephone interviews with medical oncologists (n = 14; 10 academic, 4 in the community) recruited through oncology clinics, professional advertisements, and referrals. Interviews were analyzed for anticipated and emergent themes using the constant comparative method including searches for disconfirming evidence. Some oncologists considered GEP to be a tool that enhanced confidence in their established approach to risk assessments, whereas others described it as "critical" to resolving their uncertainty about whether to recommend chemotherapy. Some community oncologists also valued the test in interpreting what they considered variable practice and accuracy across pathology reports and testing facilities. However, concerns were also raised about GEP's cost, overuse, inappropriate use, and over-reliance on the results within the medical community. In addition, although many oncologists said it wa...Continue Reading

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Citations

Dec 30, 2015·Nursing Outlook·Janet K WilliamsKathleen T Hickey
Apr 10, 2016·Breast Cancer Research and Treatment·Chalanda N EvansSuzanne C O'Neill
Apr 29, 2016·Cancer Investigation·Megan C RobertsStephanie B Wheeler
May 8, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Karen V MacDonaldDeborah A Marshall
Dec 14, 2016·International Journal of Technology Assessment in Health Care·Megan C RobertsStephanie B Wheeler
Dec 9, 2016·Breast Cancer Research and Treatment·Anne A EatonMahmoud El-Tamer

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