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.
Key words
joint decision-making - gene expression analyses - medical benefit - molecular genomic
individualization
