ArticleJournal of oncology practice2012
Barriers to the use of personalized medicine in breast cancer.
Article in Journal of oncology practice, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Factors Associated With Implementation of Biomarker Testing and Strategies to Improve Its Clinical Uptake in Cancer Care: Systematic Review Using Theoretical Domains Framework.JCO precision oncology · 2025Pooled it
- Accounting for Capacity Constraints in Economic Evaluations of Precision Medicine: A Systematic Review.PharmacoEconomics · 2019Pooled it
- Randomized trial of proactive rapid genetic counseling versus usual care for newly diagnosed breast cancer patients.Breast cancer research and treatment · 2018Trial
- Assessing barriers to genomic testing in breast cancer among diverse patients: a qualitative community-engaged research study.Breast cancer research and treatment · 2025Article
- Disparities in OncotypeDx Testing and Subsequent Chemotherapy Receipt by Geography and Socioeconomic Status.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions.JCO oncology practice · 2023Article
- Grading of invasive breast carcinoma: the way forward.Virchows Archiv : an international journal of pathology · 2022Review
- Navigating Access to Cancer Care: Identifying Barriers to Precision Cancer Medicine.Ethnicity & disease · 2022Article
- Patients' and professionals' views related to ethical issues in precision medicine: a mixed research synthesis.BMC medical ethics · 2021Review
- Success Factors and Barriers in Combining Personalized Medicine and Patient Centered Care in Breast Cancer. Results from a Systematic Review and Proposal of Conceptual Framework.Journal of personalized medicine · 2021Review
- Perspectives on a Way Forward to Implementation of Precision Medicine in Patients With Diabetic Kidney Disease; Results of a Stakeholder Consensus-Building Meeting.Frontiers in pharmacology · 2021Article
- Implementing Interventions with Varying Marginal Cost-Effectiveness: An Application in Precision Medicine.Medical decision making : an international journal of the Society for Medical Decision Making · 2020Article
- Patient and physician factors associated with Oncotype DX and adjuvant chemotherapy utilization for breast cancer patients in New Hampshire, 2010-2016.BMC cancer · 2020Article
- Clinical predictors of a positive test result in patients undergoing genetic evaluation for a hereditary kidney cancer syndrome.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2020Article
- Novel quantitative signature of tumor stromal architecture: polarized light imaging differentiates between myxoid and sclerotic human breast cancer stroma.Biomedical optics express · 2020Article
- Current Status and Future Opportunities in Lung Precision Medicine Research with a Focus on Biomarkers. An American Thoracic Society/National Heart, Lung, and Blood Institute Research Statement.American journal of respiratory and critical care medicine · 2018Article
- The Implementation Process for Pharmacogenomic Testing for Cancer-Targeted Therapies.Journal of personalized medicine · 2018Article
- Understanding barriers to the introduction of precision medicines in non-small cell lung cancer: A qualitative interview protocol.Wellcome open research · 2018Article
- Renal cell cancers: unveiling the hereditary ones and saving lives-a tailored diagnostic approach.International urology and nephrology · 2017Review
- The strategic defense of physician autonomy: State public health agencies as countervailing powers.Social science & medicine (1982) · 2017Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePersonalized medicine--the use of genomics and molecular diagnostics to direct care decisions--may improve outcomes by more accurately individualizing treatment to patients. Using qualitative research, we explored care delivery barriers to the use of personalized medicine for patients with breast cancer using examples of BRCA and gene expression profile testing.
methodsWe conducted 51 interviews with multidisciplinary stakeholders in breast cancer care: clinicians (n = 25) from three academic and nine nonacademic organizations, executives (n = 20) from four major private insurers, and patient advocates (n = 6).
resultsBarriers were common to the BRCA and gene expression profile tests and were classified under two categories: poor coordination of tests relative to treatment decisions and reimbursement-related disincentives. Perception of specific barriers varied across groups. Difficulty coordinating diagnostics relative to decisions was the most frequent concern by clinicians (60%), but only 35% of payers and 17% of advocates noted this barrier. For 60% of payers, drug- and procedure-based reimbursement was a significant barrier, but only 40% of clinicians and none of the advocates expressed the same concern. The opinion that patient out-of-pocket expenses are a barrier varied significantly between advocates and clinicians (83% v 20%, P < .007), and advocates and payers (83% v 15%, P < .004). Barriers were reported to result in postponement or avoidance of tests, delayed treatment decisions, and proceeding with decisions before test results.
conclusionPoorly coordinated diagnostic testing and the current oncology reimbursement model are barriers to the use of genomic and molecular diagnostic tests in cancer care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.