Genomic Test Results for Early Stage Breast Cancer

Author: American Cancer Society
Published: 2010/03/08 - Updated: 2025/04/22
Publication Details: Peer-Reviewed, Findings
Category Topic: Breast Cancer - Academic Publications

Page Content: Synopsis - Introduction - Main - Insights, Updates

Synopsis: This peer-reviewed article, published in CANCER by the American Cancer Society, examines how women with early-stage breast cancer interpret genomic test results like Oncotype DX, which predicts recurrence risk and guides chemotherapy decisions. While most patients found the testing valuable for understanding treatment options, a third reported incomplete comprehension of risk discussions, and a quarter experienced distress upon receiving results. The findings highlight the need for clearer communication about recurrence risks and treatment trade-offs, offering actionable insights for patients - including seniors and those with disabilities - navigating complex care decisions without unnecessary overtreatment - Disabled World (DW).

Defining Genomic Testing

Genomic Testing: Genomic testing is a sophisticated diagnostic approach that involves analyzing the entire genome or specific parts of an individual's DNA to identify genetic variations, mutations, or patterns that are associated with health conditions, disease susceptibility, or response to treatment. Unlike traditional genetic testing, which primarily looks at specific genes known to be associated with particular disorders, genomic testing examines a broader scope, including gene expression, interactions between genes, and how these genetic factors influence disease progression and treatment efficacy. This method is pivotal in personalized medicine, offering insights into the molecular basis of diseases like cancer, enabling tailored therapeutic strategies, predicting drug responses, and identifying potential hereditary risks, thereby guiding more effective and individualized patient care.

Introduction

Genomic testing is an increasingly important part of care for patients after they are diagnosed with early stage breast cancer. A new study has found that one in three early-stage breast cancer patients who received genomic testing when deciding about treatment options felt they did not fully understand their discussions with physicians about their test results and their risk of recurrence. About one in four experienced distress when receiving their test results.

Main Content

Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings suggest there is room for improvement in communicating cancer recurrence risks and treatment decisions with patients.

Genomic testing is an increasingly important part of care for patients after they are diagnosed with early stage breast cancer. The test, which looks at 21 genes in breast tumors removed during surgery, can indicate the chance the patient's cancer will recur. Such information can help guide decisions by physicians and patients about chemotherapy treatments.

Patients with a high risk of recurrence may opt for more aggressive treatment, while those with lower risk may safely avoid over-treatment and its potential side effects. It can be challenging, however, for physicians to determine the best way to talk to patients about their test results and to use the results to make important treatment decisions with patients. Currently, there is little consensus regarding the most effective method to communicate risk information to patients.

Noel Brewer, PhD, assistant professor of health behavior and health education at University of North Carolina's Gillings School of Global Public Health, and Janice Tzeng, MPH, who worked on this study as a graduate student at the school, led a team that examined how women with breast cancer received and understood cancer recurrence risk information after receiving a genomic diagnostic test called Oncotype DX, that is gaining widespread acceptance by oncologists and insurers.

To find out more about women's reactions, investigators mailed surveys to 77 women with early-stage, estrogen receptor-positive breast cancer who received Oncotype DX between 2004 and 2009. The study was funded by a five-year grant from the American Cancer Society.

"Almost all women agreed that having the test gave them a better understanding of their treatment options' chances of success," said Brewer. "Most women said that they would have the test if they had to decide again today, and that they would recommend the test to other women in their same situation," he added. Also, most women accurately recalled their genomic-based recurrence risk results, he said.

These findings suggest that patients have a positive attitude about genomic testing, and testing helps them better understand their treatment options.

While many women understood discussions about their genomic test results, a third reported not fully understanding these discussions. Although 87 percent of women received a low or intermediate breast cancer recurrence risk score, about a quarter of the women experienced distress when receiving their test results. The authors concluded that their findings suggest a need to improve risk communication and treatment decision making after patients undergo genomic testing.

"Women's experiences with genomic testing for breast cancer recurrence risk." Janice P. Tzeng, Deborah Mayer, Alice R. Richman, Isaac Lipkus, Paul K. Han, Carmina G. Valle, Lisa A. Carey, and Noel T. Brewer. CANCER ; Published Online: March 8, 2010.

Insights, Analysis, and Developments

Editorial Note: Genomic testing represents a leap forward in personalized cancer care, yet this study underscores a critical gap: even the most precise data falters without effective patient-clinician dialogue. For vulnerable groups, such as older adults or those managing disabilities, bridging this communication divide isn't just about better outcomes - it's about ensuring dignity in decision-making, where clarity and compassion meet cutting-edge science. While genomic testing offers remarkable insights into breast cancer prognosis and treatment, this study reminds us that medical innovation must be matched by compassionate, clear communication. As diagnostic technology advances, the human side of healthcare - ensuring patients truly understand their options - becomes even more critical, particularly for vulnerable groups like seniors and individuals with disabilities who may face additional barriers to medical comprehension - Disabled World (DW).

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by American Cancer Society and published on 2010/03/08, this content may have been edited for style, clarity, or brevity.