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Current Oncology
Volume 24
Issue 2
10.3747/co.24.3457
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Article

Multigene Expression Profile Testing in Breast Cancer: Is There a Role for Family Physicians?

by
M.A. O’Brien
1,*,
J.C. Carroll
1,
D.P. Manca
2,
B. Miedema
3,
P.A. Groome
1,
T. Makuwaza
1,
J. Easley
2,
N. Sopcak
2,
L. Jiang
1,
K. Decker
4,
M.L. McBride
5,
R. Moineddin
1,
J.A. Permaul
1,
R. Heisey
1,
E.A. Eisenhauer
1,
M.K. Krzyzanowska
1,
S. Pruthi
6,
C. Sawka
1,
N. Schneider
7,
J. Sussman
1,
R. Urquhart
8,
C. Versaevel
7 and
E. Grunfeld
1 for the Canadian Team to Improve Community-Based Cancer Care Along the Continuumadd Show full author list remove Hide full author list
1
Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
2
Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
3
Department of Family Medicine, Dalhousie University, Fredericton, NB, Canada
4
CancerCare Manitoba, Winnipeg, MB, Canada
5
BC Cancer Agency, Vancouver, BC, Canada
6
General Internal Medicine, Mayo Clinic, Rochester, MN, USA
7
Independent (Schneider, Versaevel), Canada
8
Beatrice Hunter Cancer Research Institute, Halifax, NS, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2017, 24(2), 95-102; https://doi.org/10.3747/co.24.3457
Submission received: 8 January 2017 / Revised: 5 February 2017 / Accepted: 7 March 2017 / Published: 1 April 2017

Abstract

Background: Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing. Methods: We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program. We determined the number of visits by breast cancer patients to a fp between the first medical oncology visit and the start of chemotherapy, a period when patients might be considering results of gep testing. Results: The fps and cancer specialists felt that ordering gep tests and explaining the results was the role of the oncologist. A new fp role was identified relating to the fp–patient relationship: supporting patients in making adjuvant therapy decisions informed by gep tests by considering the patient’s comorbid conditions, social situation, and preferences. Lack of fp knowledge and resources, and challenges in fp–oncologist communication were seen as significant barriers to that role. Between 28% and 38% of patients visited a fp between the first oncology visit and the start of chemotherapy. Conclusions: Our findings suggest an emerging role for fps in supporting patients who are making adjuvant treatment decisions after receiving the results of gep testing. For success in this new role, education and point-of-care tools, together with more effective communication strategies between fps and oncologists, are needed.
Keywords: personalized medicine; gene expression profile testing; breast cancer personalized medicine; gene expression profile testing; breast cancer

Share and Cite

MDPI and ACS Style

O’Brien, M.A.; Carroll, J.C.; Manca, D.P.; Miedema, B.; Groome, P.A.; Makuwaza, T.; Easley, J.; Sopcak, N.; Jiang, L.; Decker, K.; et al. Multigene Expression Profile Testing in Breast Cancer: Is There a Role for Family Physicians? Curr. Oncol. 2017, 24, 95-102. https://doi.org/10.3747/co.24.3457

AMA Style

O’Brien MA, Carroll JC, Manca DP, Miedema B, Groome PA, Makuwaza T, Easley J, Sopcak N, Jiang L, Decker K, et al. Multigene Expression Profile Testing in Breast Cancer: Is There a Role for Family Physicians? Current Oncology. 2017; 24(2):95-102. https://doi.org/10.3747/co.24.3457

Chicago/Turabian Style

O’Brien, M.A., J.C. Carroll, D.P. Manca, B. Miedema, P.A. Groome, T. Makuwaza, J. Easley, N. Sopcak, L. Jiang, K. Decker, and et al. 2017. "Multigene Expression Profile Testing in Breast Cancer: Is There a Role for Family Physicians?" Current Oncology 24, no. 2: 95-102. https://doi.org/10.3747/co.24.3457

APA Style

O’Brien, M. A., Carroll, J. C., Manca, D. P., Miedema, B., Groome, P. A., Makuwaza, T., Easley, J., Sopcak, N., Jiang, L., Decker, K., McBride, M. L., Moineddin, R., Permaul, J. A., Heisey, R., Eisenhauer, E. A., Krzyzanowska, M. K., Pruthi, S., Sawka, C., Schneider, N., ... Grunfeld, E., for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum. (2017). Multigene Expression Profile Testing in Breast Cancer: Is There a Role for Family Physicians? Current Oncology, 24(2), 95-102. https://doi.org/10.3747/co.24.3457

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