Metastatic breast cancer patient perceptions of somatic tumor genomic testing
Open Access
- 6 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Cancer
- Vol. 20 (1), 1-11
- https://doi.org/10.1186/s12885-020-06905-2
Abstract
To assess metastatic breast cancer (MBC) patient psychological factors, perceptions, and comprehension of tumor genomic testing. In a prospective, single institution, single-arm trial, patients with MBC underwent next-generation sequencing at study entry with sequencing results released at progression. Patients who completed surveys before undergoing sequencing were included in the present secondary analysis (n = 58). We administered four validated psychosocial measures: Center for Epidemiologic Studies Depression Scale, Beck Anxiety Inventory, Trust in Physician Scale, and Communication and Attitudinal Self-Efficacy scale for Cancer. Genetic comprehension was assessed using 7-question objective and 6-question subjective measures. Longitudinal data were assessed (n = 40) using paired Wilcoxon signed rank and McNemar’s test of agreement. There were no significant differences between the beginning and end of study in depression, anxiety, physician trust, or self-efficacy (median time on study: 7.6 months). Depression and anxiety were positively associated with each other and both negatively associated with self-efficacy. Self-efficacy decreased from pre- to post-genomic testing (p = 0.05). Objective genetics comprehension did not significantly change from pre- to post-genomic testing, but patients expressed increased confidence in their ability to teach others about genetics (p = 0.04). Objective comprehension was significantly lower in non-white patients (p = 0.02) and patients with lower income (p = 0.04). This is the only study, to our knowledge, to longitudinally evaluate multiple psychological metrics in MBC as patients undergo tumor genomic testing. Overall, psychological dimensions remained stable over the duration of tumor genomic testing. Among patients with MBC, depression and anxiety metrics were negatively correlated with patient self-efficacy. Patients undergoing somatic genomic testing had limited genomic knowledge, which varied by demographic groups and may warrant additional educational intervention. NCT01987726, registered November 13, 2013.Keywords
Other Versions
Funding Information
- Stefanie Spielman Fund (NA)
- Pelotonia (NA, NA)
This publication has 45 references indexed in Scilit:
- Attitudes of Patients With Cancer About Personalized Medicine and Somatic Genetic TestingJournal of Oncology Practice, 2012
- The Genetic Basis for Cancer Treatment DecisionsCell, 2012
- CA-125 can be part of the tumour evaluation criteria in ovarian cancer trials: experience of the GCIG CALYPSO trialBritish Journal of Cancer, 2012
- Tailored chemotherapy based on tumour gene expression analysis: breast cancer patients' misinterpretations and positive attitudesEuropean Journal of Cancer Care, 2011
- Insight into the heterogeneity of breast cancer through next-generation sequencingJCI Insight, 2011
- Deploying whole genome sequencing in clinical practice and public health: Meeting the challenge one bin at a timeGenetics in Medicine, 2011
- Decrease in Depression Symptoms Is Associated With Longer Survival in Patients With Metastatic Breast Cancer: A Secondary AnalysisJournal of Clinical Oncology, 2011
- How does communication heal? Pathways linking clinician–patient communication to health outcomesPatient Education and Counseling, 2009
- Psychological impact of genetic testing for cancer susceptibility: an update of the literaturePsycho‐Oncology, 2005
- The CES-D ScaleApplied Psychological Measurement, 1977