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Breast Cancer Multigene Testing Trends and Impact on Chemotherapy Use
G. Thomas Ray, MBA; Jeanne Mandelblatt, MD; Laurel A. Habel, PhD; Scott Ramsey, MD, PhD; Lawrence H. Kushi, ScD; Yan Li, MD; and Tracy A. Lieu, MD, MPH
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Breast Cancer Multigene Testing Trends and Impact on Chemotherapy Use

G. Thomas Ray, MBA; Jeanne Mandelblatt, MD; Laurel A. Habel, PhD; Scott Ramsey, MD, PhD; Lawrence H. Kushi, ScD; Yan Li, MD; and Tracy A. Lieu, MD, MPH
A multigene test for breast cancer recurrence risk was used in a minority of eligible patients, yet was associated with a decrease in chemotherapy use.
Overall, this study suggests that in a large integrated healthcare system, the 21-gene test is used in a minority of eligible patients, but when used, it is leading to clinically appropriate patterns of chemotherapy use. Optimizing the benefit and efficiency of this and other genomic tests for cancer patients will require additional research on the factors that drive test use and subsequent decisions about chemotherapy. 


Author Affiliations: Division of Research, Kaiser Permanente Northern California (GTR, LAH, LHK, TAL), Oakland, CA; Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center (JM), Washington, DC; Fred Hutchinson Cancer Research Center (SR), Seattle, WA; Department of Oncology, Kaiser Permanente Oakland Medical Center (YL), Oakland, CA.

Source of Funding: This work was funded by grant #U01CA183081 from the National Cancer Institute at the National Institutes of Health. This work was also supported in part by the following National Cancer Institute grants: R01 CA105274; U19 CA079689; U24 CA171524; U01 CA152958; and UC2 CA148471.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article. All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the National Institutes of Health.

Authorship Information: Concept and design (GTR, JM, LAH, TAL); acquisition of data (GTR, LAH, LHK, TAL); analysis and interpretation of data (GTR, JM, LAH, LHK, TAL, SR, YL); drafting of the manuscript (GTR, JM, LAH, LHK, TAL, SR, YL); critical revision of the manuscript for important intellectual content (GTR, JM, LAH, LHK, TAL, SR, YL); statistical analysis (GTR); obtaining funding (JM, TAL).

Address correspondence to: G. Thomas Ray, MBA, Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612. E-mail:

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