Personalizing the Treatment of Women with Ductal Carcinoma In Situ (DCIS) Using the DCIS Score: A Qualitative Study on Score Use

A twelve-gene molecular expression assay (DCIS score) may help guide radiation oncology treatment under specific circumstances. We undertook a study to examine radiation oncologist (RO), surgeon, and decision maker views on implementing the DCIS score in practice for women with low-risk DCIS. We con...

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Bibliographic Details
Published in:Current oncology (Toronto) 2024-02, Vol.31 (2), p.975-986
Main Authors: O'Brien, Mary Ann, Paszat, Lawrence, Makuwaza, Tutsirai, Fong, Cindy, Rakovitch, Eileen
Format: Article
Language:English
Subjects:
Analysis
Breast Neoplasms - pathology
carcinoma
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating - pathology
Carcinoma, Intraductal, Noninfiltrating - therapy
decision making
Female
Humans
implementation science
intraductal
noninfiltrating
Qualitative Research
Radiation
radiation oncology
Radiotherapy
Reactive Oxygen Species
Risk
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Summary:A twelve-gene molecular expression assay (DCIS score) may help guide radiation oncology treatment under specific circumstances. We undertook a study to examine radiation oncologist (RO), surgeon, and decision maker views on implementing the DCIS score in practice for women with low-risk DCIS. We conducted a qualitative study involving telephone interviews that were audio-recorded and transcribed. Two researchers conducted a thematic analysis of transcripts. Twenty-eight individuals (ROs, breast cancer surgeons, and cancer policy decision makers) were invited to participate; 22 out of the 28 people (79%) agreed. The final sample included 20 participants: 11 of 13 (85%) ROs, 5 of 7 (71%) surgeons, and 4 of 8 (50%) decision makers. Most ROs expressed concerns about overtreatment but could not predict with certainty which low-risk patients could safely avoid radiation. The DCIS score was viewed as contributing valuable personalized risk information as part of treatment decision making that included clinicopathological factors and women's preferences. Future implementation would require guidelines with input from the oncology team. ROs had concerns about the overtreatment of women with DCIS, but lacked the tools to reliably predict which women could safely avoid radiation. By providing oncologists and women with personalized tumor information, the DCIS score was an important component of treatment decision making.
ISSN:1718-7729
1198-0052
1718-7729
DOI:10.3390/curroncol31020073