Q&A With Dr Christopher Friese: Recurrence Score Assay for Early-stage Breast Cancer

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Debra Hughes, MS, spoke to Dr Friese about the recurrence score assay use in breast cancer.
Debra Hughes, MS, spoke to Dr Friese about the recurrence score assay use in breast cancer.

A survey of chemotherapy-related decisions and patient experience with the 21-gene recurrence score assay, which stratifies early-stage, estrogen receptor-positive breast cancer by recurrence risk, found that oncologists use the test to inform treatment recommendations with high patient satisfaction. But 40% of patients did not accurately recall test details.

This represents a key opportunity to ensure women are adequately educated about the assay. Cancer Therapy Advisor interviewed Christopher Friese, PhD, RN, a professor at the University of Michigan School of Nursing in Ann Arbor, about the study, which was recently published in Cancer.1

Cancer Therapy Advisor (CTA): What was the reason for your study of patient experience with the recurrence score assay for early-stage breast cancer?

Dr Friese: Our team was motivated to continue our work in patient-centered cancer research. Many have heard of Vice President Biden's Moonshot initiative, which seeks to expand the use of precision medicine for cancer care. Precision medicine means using advanced tests to more narrowly plan cancer treatment. An early example of precision medicine can be found in early-stage breast cancer. Since 2004, a test of the genes found in breast tumors has helped doctors identify which women are at greater risk for their cancer to return. This test also examines the benefit of chemotherapy. We wanted to examine how the test is being used to inform chemotherapy decisions in a large, diverse sample of women.

CTA: What percentage of women with breast cancer have early-stage, estrogen receptor-positive disease?

Dr Friese: Recent National Cancer Institute estimates suggest that over half of all women in the United States with breast cancer present with early stage, estrogen receptor-positive disease.

CTA: What might be some barriers to obtaining a recurrence score: access, insurance, cost?

Dr Friese: Our clinical partners suggest that women with insurance who meet clinical criteria are often able to have at least one assay performed on their initial breast tumor. We are not aware of evidence that copays for this test are unreasonable. The barriers are more likely on the clinic side, where a biopsy is performed and the tumor tissue is not sent by the doctor. In some cases, doctors may feel the tumor is too small to obtain an accurate result.

CTA: For the 12.3% of the women surveyed who reported that their oncologists left the decision regarding systemic chemotherapy to them, did the survey results capture whether this shifted their decision one way or the other, based on the recurrence score results?

Dr Friese: Given the relatively small number of patients in that group, we are still exploring this question. Stay tuned!

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