Abstract
Rapid autopsy (RA) offers a unique opportunity to obtain a large amount of metastatic tissue at death in order to deepen existing understanding of cancer evolution and heterogeneity. In breast cancer, understanding metastasis is particularly valuable given that treatment regimens are based on the traditional hormone and HER2 receptor status as well as evolving genomic data of the primary tumor. We aimed to elucidate the attitudes and interests of patients with metastatic breast cancer (MBC) toward RA, and to identify associated demographic or disease characteristics that may influence patient attitudes and interest. Ninety-seven patients with MBC were surveyed over the course of 12 months at a large, urban comprehensive cancer center’s breast cancer outpatient clinic. 93/97 patients completed the survey sufficiently to be included in the analysis. Fisher’s exact test was employed for categorical variables, and t test and rank-sum tests for continuous variables. p values ≤0.05 were considered statistically significant. Of the 93 patients with MBC analyzed, 87 % were willing to donate tissue at death. Marital status and younger age were associated with willingness to donate (p = 0.000, p = 0.025, respectively). Race, employment status, religion/spirituality, and cancer subtype were not associated with likelihood of donating. Forty-five percent of patients felt that doctors should ask about RA at diagnosis of early-stage breast cancer rather than during late-stage disease. These data provide evidence that an RA program would be welcomed by patients and requires initiative by providers.
Similar content being viewed by others
Abbreviations
- MBC:
-
Metastatic breast cancer
- UPMC:
-
University of Pittsburgh Medical Center
- RA:
-
Rapid autopsy
- RTD:
-
Rapid tissue donation
References
Schabath MB et al (2014) Healthcare providers’ knowledge and attitudes about rapid tissue donation (RTD): phase one of establishing a rapid tissue donation programme in thoracic oncology. J Med Ethics 40(2):139–142
Quinn GP et al (2013) Altruism in terminal cancer patients and rapid tissue donation program: does the theory apply? Med Health Care Philos 16(4):857–864
Spunt SL et al (2012) The clinical, research, and social value of autopsy after any cancer death: a perspective from the Children’s Oncology Group Soft Tissue Sarcoma Committee. Cancer 118(12):3002–3009
Almendro V et al (2014) Genetic and phenotypic diversity in breast tumor metastases. Cancer Res 74(5):1338–1348
Alabran JL et al (2013) Overcoming autopsy barriers in pediatric cancer research. Pediatr Blood Cancer 60(2):204–209
McIntyre J et al (2013) Stakeholder perceptions of thoracic rapid tissue donation: an exploratory study. Soc Sci Med 99:35–41
Horne G, Seymour J, Payne S (2012) Maintaining integrity in the face of death: a grounded theory to explain the perspectives of people affected by lung cancer about the expression of wishes for end of life care. Int J Nurs Stud 49(6):718–726
Zhou X et al (2015) Alterations of biomarker profiles after neoadjuvant chemotherapy in breast cancer: tumor heterogeneity should be taken into consideration. Oncotarget 6(34):36894–36902
Brooks MD, Burness ML, Wicha MS (2015) Therapeutic implications of cellular heterogeneity and plasticity in breast cancer. Cell Stem Cell 17(3):260–271
Acknowledgments
The authors would like to acknowledge the patients who participated in the focus groups at the start of this study, as well as those who completed the surveys. This study would not have been possible without their participation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Achkar, T., Wilson, J., Simon, J. et al. Metastatic breast cancer patients: attitudes toward tissue donation for rapid autopsy. Breast Cancer Res Treat 155, 159–164 (2016). https://doi.org/10.1007/s10549-015-3664-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-015-3664-0