April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Exploring Black Breast Cancer Patients’ Questions About Biomarker Testing to Predict Chemotherapy Neuropathy: A Qualitative Study
An increasing focus in precision cancer medicine (PCM) is to identify how racially diverse patients respond differentially to cancer treatments. One persistent problem is that Black women experience chemotherapy-induced neuropathy (i.e., serious nerve damage that results in numbness, tingling, and pain) at higher rates than other groups. Recent work identified a genetic biomarker that can indicate likelihood of neuropathy in Black patients and therefore could play a significant role in breast cancer treatment decisions and outcomes. This study sought to explore the information needs that Black patients may have about this biomarker test in order to best consider how to integrate the test into clinical care. Nineteen women who were previous/current breast cancer patients, lived in Indiana, and who self-identified as Black or African American were recruited into this focus group study through social media. Focus groups were conducted and recorded over Zoom, and participants were compensated with a $25 gift card for their time. During the second half of each focus group, a member of the study team briefly explained chemotherapy neuropathy and the biomarker test. Participants were then asked what questions they would have about biomarker testing and its use in breast cancer treatment decisions. These participant-voiced questions composed the data for this study. The lead author analyzed the questions using thematic analysis. Participants’ questions centered on six themes: reasons for test (e.g., “what’s it going to do?”), integration into care (e.g., “would I still get the medicine that I need to kill this, or would my medicine be compromised or changed?”), testing procedure (e.g., “how often would the doctor perform this blood draw test on me?”), limits of test (e.g., “what is the accuracy?”), concerns about use of the test on self/others (e.g.,“so you’re going to suggest this different type of medication; well, where’s the people that went before me?”), and personal information connected to the test (e.g., “what are you going to do with my DNA information?”). This study provides an exploratory look at the questions that Black breast cancer patients may have about the use of biomarker testing in breast cancer treatment decisions. Beyond purely informational needs, such as how the test works, participants were also interested in larger issues of clinical research about the test and privacy concerns related to their own biomarker test results. While individual patients may have different questions, the ones categorized here can be used to help anticipate the information needs of Black breast cancer patients and serve as a starting point for developing patient-centered approaches for integrating this test into clinical care. Additionally, we found that eliciting and analyzing questions from women led to robust and insightful findings. Rather than focusing on participants’ answers to researcher’s questions, as is typical in interviewing research, the elicitation of questions allowed women to put themselves back in the position of being a breast cancer patient and imagine what questions they would want to ask their oncologist about this test, which may have resulted in more ecologically valid findings.