CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2017; 77(09): 984-992
DOI: 10.1055/s-0043-115396
GebFra Science
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

How Do Patients Experience Individualized Medicine? A Qualitative Interview-based Study of Gene Expression Analyses in the Treatment of Breast Cancer

Article in several languages: English | deutsch
Sebastian Schleidgen**
1  Pflegewissenschaftliche Fakultät, Philosophisch-Theologische Hochschule Vallendar, Vallendar, Germany
,
Sandra Thiersch**
2  Institut für Ethik, Geschichte und Theorie der Medizin, Ludwig-Maximilians-Universität München, München, Germany
,
Rachel Wuerstlein
3  Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum der Universität München, München, Germany
4  Comprehensive Cancer Center LMU München, München, Germany
,
Georg Marckmann
2  Institut für Ethik, Geschichte und Theorie der Medizin, Ludwig-Maximilians-Universität München, München, Germany
› Author Affiliations
Further Information

Publication History

received 05 May 2017
revised 27 June 2017

accepted 30 June 2017

Publication Date:
25 September 2017 (online)

  

Abstract

Introduction In recent years, the hopes and expectations associated with so-called individualized medicine have been the subject of intense debate as has the medical potential of this approach. Questions about the uses of gene expression analyses for decisions on adjuvant systemic treatment options for patients with breast cancer have played a prominent role in this debate. There are a number of empirical studies on the effect of gene expression tests on the therapy decisions of physicians and the potentially conflicted decisions for patients. Very little attention has been paid to how patients perceive such approaches, the extent to which they feel included in the therapy decision, and the expectations they associate with such an approach.

Material and Methods Using qualitative explorative interviews, the study looked at how well patients with breast cancer understood the individualized treatment approaches and examined patientsʼ experiences and expectations with regard to gene expression analyses. The sample consisted of 8 patients who were diagnosed with primary hormone receptor-positive, HER2-negative breast cancer between 2013 and 2014 and who underwent gene expression analyses as part of their adjuvant therapy planning.

Results Patients were found to have a quite realistic view of the benefits of gene expression analyses, although it also became clear that the treatment could also raise false hopes. The statements by the interviewed women also illustrated the necessity of continuing to explore the possibilities and limits to joint decision-making in such complex medical contexts as individualized molecular genomic medicine. And finally, the interviews reflected the hope for individualized treatment in the broadest sense of the word.

Conclusion The results of the study highlight the challenge of taking psychosocial aspects of medical treatment sufficiently into consideration, given the ever increasing options for molecular genomic individualization.

* Shared first authorship