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Article: The Impact of the Oncotype DX Breast Cancer Assay on Treatment Decisions for Women With Estrogen Receptor-Positive, Node-Negative Breast Carcinoma in Hong Kong

TitleThe Impact of the Oncotype DX Breast Cancer Assay on Treatment Decisions for Women With Estrogen Receptor-Positive, Node-Negative Breast Carcinoma in Hong Kong
Authors
KeywordsDecision support techniques
Adjuvant drug therapy
Risk assessment
Neoplasms
Molecular diagnostic techniques
Issue Date2016
PublisherCancer Information Group, LP.
Citation
Clinical Breast Cancer, 2016, v. 16, p. 372-378 How to Cite?
AbstractBackground The Oncotype DX Breast Cancer Assay is validated to assess risk of distant recurrence and likelihood of chemotherapy (CT) benefit in estrogen receptor-positive ESBC in various populations. In Hong Kong, > 80% of breast cancers are early stage breast cancer (ESBC) and > 60% of these women receive CT. This prospective study measured changes in CT type and recommendations, as well as physician impression of assay impact in a homogenous Chinese population. Methods Consecutive patients with estrogen receptor-positive, T1-3 N0-1mi M0 ESBC were offered enrollment. After surgery, physicians discussed treatment options with patients, then ordered the assay, then reassessed treatment recommendation considering assay results. Changes in treatment recommendation, CT utilization, physician confidence, and physician rating of influence on their treatment recommendations were measured. Results A total of 146 evaluable patients received pre- and post-testing treatment recommendations. CT recommendations (including changes in intensity of CT) were changed for 34 of 146 patients (23.3%; 95% confidence interval, 16.7%-31.0%); change in intensity occurred in 7 of 146 (4.8%). There were 27 changes in treatment recommendations of adding or removing CT altogether (18.5% change; 95% confidence interval, 12.6%-25.8%). CT recommendations decreased from 52.1% to 37.7%, a net absolute reduction of 14.4% (P < .001; 27.6% net relative reduction). Pre-assay, 96% of physicians agreed/strongly agreed that they were confident in their treatment recommendation; post-assay, 90% of physicians agreed/strongly agreed with the same statement. Thirty percent of physicians agreed/strongly agreed that the test had influenced their recommendation, similar to the proportion of changed recommendations. Conclusions The Oncotype DX Assay appears to influence physician ESBC adjuvant treatment recommendations in Hong Kong.
Persistent Identifierhttp://hdl.handle.net/10722/236417
ISSN
2019 Impact Factor: 2.647
2015 SCImago Journal Rankings: 1.030
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, RCY-
dc.contributor.authorYau, TCC-
dc.contributor.authorChan, MC-
dc.contributor.authorChan, SW-
dc.contributor.authorChan, TW-
dc.contributor.authorTsang, YY-
dc.contributor.authorWong, TT-
dc.contributor.authorChao, C-
dc.contributor.authorYoshizawa, C-
dc.contributor.authorSoong, IS-
dc.contributor.authorKwan, WH-
dc.contributor.authorKwok, CC-
dc.contributor.authorSuen, JS-
dc.contributor.authorNgan, RK-
dc.contributor.authorCheung, PS-
dc.date.accessioned2016-11-25T00:53:05Z-
dc.date.available2016-11-25T00:53:05Z-
dc.date.issued2016-
dc.identifier.citationClinical Breast Cancer, 2016, v. 16, p. 372-378-
dc.identifier.issn1526-8209-
dc.identifier.urihttp://hdl.handle.net/10722/236417-
dc.description.abstractBackground The Oncotype DX Breast Cancer Assay is validated to assess risk of distant recurrence and likelihood of chemotherapy (CT) benefit in estrogen receptor-positive ESBC in various populations. In Hong Kong, > 80% of breast cancers are early stage breast cancer (ESBC) and > 60% of these women receive CT. This prospective study measured changes in CT type and recommendations, as well as physician impression of assay impact in a homogenous Chinese population. Methods Consecutive patients with estrogen receptor-positive, T1-3 N0-1mi M0 ESBC were offered enrollment. After surgery, physicians discussed treatment options with patients, then ordered the assay, then reassessed treatment recommendation considering assay results. Changes in treatment recommendation, CT utilization, physician confidence, and physician rating of influence on their treatment recommendations were measured. Results A total of 146 evaluable patients received pre- and post-testing treatment recommendations. CT recommendations (including changes in intensity of CT) were changed for 34 of 146 patients (23.3%; 95% confidence interval, 16.7%-31.0%); change in intensity occurred in 7 of 146 (4.8%). There were 27 changes in treatment recommendations of adding or removing CT altogether (18.5% change; 95% confidence interval, 12.6%-25.8%). CT recommendations decreased from 52.1% to 37.7%, a net absolute reduction of 14.4% (P < .001; 27.6% net relative reduction). Pre-assay, 96% of physicians agreed/strongly agreed that they were confident in their treatment recommendation; post-assay, 90% of physicians agreed/strongly agreed with the same statement. Thirty percent of physicians agreed/strongly agreed that the test had influenced their recommendation, similar to the proportion of changed recommendations. Conclusions The Oncotype DX Assay appears to influence physician ESBC adjuvant treatment recommendations in Hong Kong.-
dc.languageeng-
dc.publisherCancer Information Group, LP.-
dc.relation.ispartofClinical Breast Cancer-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectDecision support techniques-
dc.subjectAdjuvant drug therapy-
dc.subjectRisk assessment-
dc.subjectNeoplasms-
dc.subjectMolecular diagnostic techniques-
dc.titleThe Impact of the Oncotype DX Breast Cancer Assay on Treatment Decisions for Women With Estrogen Receptor-Positive, Node-Negative Breast Carcinoma in Hong Kong-
dc.typeArticle-
dc.identifier.emailYau, TCC: tyaucc@hku.hk-
dc.identifier.authorityYau, TCC=rp01466-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.clbc.2016.03.002-
dc.identifier.pmid27105769-
dc.identifier.scopuseid_2-s2.0-84963819297-
dc.identifier.hkuros270520-
dc.identifier.volume16-
dc.identifier.spage372-
dc.identifier.epage378-
dc.identifier.isiWOS:000386603600007-
dc.publisher.placeUnited States-

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