Patient-Centered Communication for Discussing Oncotype DX Testing

ABSTRACT

Oncotype DX testing (ODX), a tumor gene expression test, may improve breast cancer care, however, communicating results remains challenging. We identified patient-centered communication strategies/gaps for discussing ODX results. We applied a patient-centered communication framework to analyze qualitative interviews with oncologists about how they communicate about ODX with patients, using template analysis in Atlas.ti. Overall, providers discussed four patient-centered communication domains: exchanging information, assessing uncertainty, making decisions and cross-cutting themes. Providers did not report discussing emotional aspects of managing uncertainty, assessing decision-making preferences, and evaluating decisions. A patient-centered approach may be a model for communicating about tumor gene expression tests.

KEYWORDS:

• Breast cancer
• Patient-centered communication
• Communication
• Tumor gene profiling
• Qualitative methods

Funding

Dr. Roberts received funding for this work from the UNC Lineberger Cancer Control Education Program (R25 CA57726). Dr. Weinberger is a VA HSR&D Senior Research Career Scientist (RCS 91–408). Dr. Dusetzina received support from the NIH Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 Program and the North Carolina Translational and Clinical Sciences Institute (UL1TR001111). Dr. Dinan received support from the AHRQ K99 R00 and K99 HS022189 awards. Dr. Reeder-Hayes received salary support from the National Institutes of Health, Building Interdisciplinary Careers in Women's Health (BIRCWH) Career Development Program, 5K12HD001441-12 (Orringer, Gene). Dr. Wheeler's salary support was through the Agency for Healthcare Research and Quality (AHRQ) Comparative Effectiveness Research Career Development Award, 1-K-12 HS019468-01 (Weinberger) and an American Cancer Society Mentored Research Scholar Award, MRSG-13-17-01-CPPB (Wheeler).