Characterizing patient-oncologist communication in genomic tumor testing: The 21-gene recurrence score as an exemplar

• Published in: Patient education and counseling 2021-02, Vol.104 (2), p.250-256
• Main Authors: O’Neill, Suzanne C., Vadaparampil, Susan T., Street, Richard L., Moore, Tanina Foster, Isaacs, Claudine, Han, Hyo S., Augusto, Bianca, Garcia, Jennifer, Lopez, Katherine, Brilleman, Matilda, Jayasekera, Jinani, Eggly, Susan
• Format: Article
• Language: English
• Subjects: 21-gene; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - drug therapy; Breast Neoplasms - genetics; Clinical Decision-Making; Communication; Decision Making; Female; Genomics; Humans; Neoplasm Recurrence, Local - genetics; Oncologists; Patient-clinician communication; Shared decision making; Uncertainty
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2020.08.037

•Effective patient-provider communication is essential for proper use of genomic testing.•Women with breast cancer can have testing for their risk of recurrence (low/intermediate/high).•Women with high risk scores experience more elements of shared decision making than others.•Patient-centered communication and active participation are high regardless of risk score. Women with early-stage, ER + breast cancer are recommend to receive genomic profiling tests, such as the 21-gene Recurrence Score (RS) test, to guide treatment decisions. We examined test- and treatment-related information discussed and the associations between RS categories and aspects of communication during patient-oncologist clinical encounters. As part of a larger trial, clinical encounters (N = 46) were audiorecorded and coded for 1) RS- and treatment-related information, 2) shared decision making, 3) patient active participation, and 4) oncologist patient-centered communication. We examined differences by RS category using mixed models, adjusting for nesting within oncologist. Patients with a high RS were more likely to receive a chemotherapy recommendation (p