What treatment? The outcome matters!

The importance of early diagnosis

The campaign focuses on the role of diagnostics as the foundation of therapeutic decisions in early breast cancer. The results of diagnostic tests are an important part of the doctor-patient conversation and allow a better understanding of the nature of the disease at the treatment planning stage. Depending on the type of breast cancer and its biological features, the oncologist can suggest a therapeutic strategy best suited to the specific clinical situation.

The development of modern diagnostics, including multigene tests that allow a more accurate assessment of tumor biology, creates the conditions for a more informed and rational approach to treatment. In this context, their importance is increasingly emphasized as an element that complements standard clinical assessment and supports the personalization of therapy, responding to both the needs of patients and the challenges of the health care system.

Patients' voice: need for certainty and understanding of decisions

An important context for the campaign is the experiences and expectations of women themselves facing a breast cancer diagnosis. A survey of Polish women's attitudes toward solutions that support breast cancer diagnosis and treatment found that 84%[1] of patients report greater confidence and acceptance of treatment if the therapeutic decision - including whether or not to receive chemotherapy - is based on additional, objective diagnostic information.

For many women, the test result becomes not only part of the medical record, but also an important reference point in the process of making difficult decisions. It helps to better understand the risks of the disease and the rationale for the proposed treatment, and thus increases a sense of security and confidence in the therapeutic process.

The use of expanded diagnostics can significantly affect patients' sense of security, their confidence in the treatment process and their willingness to take the proposed therapy.

What the campaign highlights - and why it's important

The campaign "What Treatment? The Result Matters!" highlights three key areas of importance from both the perspective of patients and the health care system.

First - equality of access to modern diagnostics, which allows therapeutic decisions to be made based on a more complete knowledge of the disease and its biology.

Second is the quality of communication and the doctor-patient partnership conversation, in which test results provide a reliable basis for discussing risks, possible benefits and treatment goals.

Third is the systemic dimension of personalizing therapy, which promotes both improved clinical outcomes and quality of life for patients and more rational use of health care resources.

"Chemotherapy remains a key component of breast cancer treatment, but the current state of knowledge shows that not every patient benefits equally from it. That's why it's so important to include multigene tests in diagnostic standards - their results can help assess the risk of recurrence and predict whether chemotherapy will benefit or not, thus avoiding unnecessary burden where there is no real clinical justification. The health care system in Poland should provide access to modern diagnostic tools, which are standard in many European countries and support personalization of therapy and improvement of patients' quality of life. And that is why we are implementing the educational campaign "What treatment? The outcome matters!", which aims to increase women's awareness of early breast cancer and the personalization of treatment and informed, well-informed dialogue between doctor and patient." - said Anna Kupiecka, president of the Onkocafe Foundation - Together Better

Diagnostics as the basis for clinical decisions

In daily clinical practice, diagnostics plays a key role in qualifying patients for systemic treatment in early breast cancer. In addition to classical clinicopathological factors, methods that allow more accurate characterization of tumor biology and more precise assessment of the risk of recurrence are of great importance.

For early, hormone-dependent, HER2-negative breast cancer, multigene tests are an important component of expanded diagnostics, providing information about an individual's risk of recurrence and having prognostic and predictive value. The results of these tests support the assessment of whether a patient may benefit from the addition of chemotherapy, or whether a less burdensome treatment strategy is possible while maintaining oncologic safety.

Dr. Katarzyna Pogoda, M.D., Clinical Oncologist in the Department of Breast Cancer and Reconstructive Surgery at the Maria Sklodowska National Cancer Institute and Chair of the PTOK Breast Cancer Section, added that "The patient, despite everything, expects clear decisions: you know about it, so you should be the one to make it. For an oncologist, it is sometimes more difficult to say: I'm not convinced that this method is necessary - let's do an additional test. It's easier to take shortcuts: young patient, so we give chemotherapy to almost everyone - often intensive. That's what we used to think, a bit inclined to over-treat. Meanwhile, medical knowledge is advancing very rapidly, and we have more and more data showing that we can't approach therapeutic decisions in such a simplistic way. We really need additional tools to treat optimally. Standards exist, of course, but in hormone-dependent cancer there remains a certain 'gray area' where uncertainties are greatest."

By including multi-gene tests in the diagnostic process, doctors can make therapeutic decisions based on a more complete clinical picture, and the conversation with the patient gains a more concrete and understandable point of reference. In this sense, diagnostics, including genomic diagnostics, is becoming a viable tool to support personalization of treatment and optimization of clinical decisions.

"Let's remember that in Poland, treatment is publicly funded and we are all active participants in this process. It should be emphasized that currently in Poland we have wide access to modern reimbursed drugs for the treatment of breast cancer. Regarding the indications for multigene testing, I would like to share my experience from training at the Gustave Roussy Institute, where the decision to qualify for a multigene test is made during a multidisciplinary consortium; moreover, a registry is kept of patients who have undergone such testing. In clinical practice, tests with prognostic-predictive value are the most successful, as they allow us to determine who to treat and how to treat them. We are awaiting reimbursement for such tests," - said Prof. Renata Duchnowska, MD, Head of the Department of Oncology at the Military Medical Institute National Research Institute in Warsaw.

Patients' perspective: treatment is also quality of life

Therapeutic decisions affect not only the course of oncological treatment, but also the daily functioning of patients - their family, professional and psychological lives. The campaign emphasizes that personalizing treatment also means taking into account the quality of life, concerns and individual needs of women facing a breast cancer diagnosis.

"A critical problem highlighted in our patients' experiences is that information about the possibility of multigene testing is often not provided in the standard manner during an oncology office visit. Instead, knowledge of these innovative diagnostic tools spreads via the panther mail - through patient organizations, support groups or from other women. This situation creates a number of negative consequences, leading to a communication gap and a lack of trust in the health care system. The drama for female patients is exacerbated when, after taking the test on their own, the result challenges the doctor's original recommendations. Among us, there are stories of women who were originally advised to forgo chemotherapy, but after taking the multi-gene test and presenting the result - the therapy was eventually switched on. This shows that even against the initial opinion, a reliable diagnostic result can change the course of treatment, which is clear evidence of the great value of these tests. It is urgently necessary to integrate multigene tests into the routine diagnostic pathway to reduce the need for patients to conduct their own "investigative diagnostics." Only in this way will Polish patients feel that their treatment is individual, informed and based on the highest standards of medicine. - Magdalena Kardynał, president of the OmeaLife Foundation, said.

"The information about the diagnosis of oncological disease is a serious mental crisis for most patients. In an instant, the order of daily life is disrupted, and many questions and negative associations about treatment and future prognosis arise. That's why communication with the doctor and a sound knowledge of the disease and available treatment options is so important. Being able to make a conscious choice of treatment, restores the sick person's sense of subjectivity and effectiveness," comments Dr. Mariola Kosowicz, MD, Psychooncology Outpatient Clinic at the Maria Curie Sklodowska Oncology Center - Institute of Warsaw .

Campaign activities

The campaign will include educational activities, including webinars, workshops, social media content and personal stories from female patients, demonstrating the importance of reliable information in the therapeutic decision-making process.

The campaign was launched at a press meeting in Warsaw. The meeting can be viewed on the YouTube channel of the Onkocafe Foundation - Together Better:[https://www.youtube.com/live/wer9prNL6jw].

Research report: Attitudes of Polish women towards systemic solutions supporting breast cancer diagnosis and therapy https://www.ioz.org.pl/_files/ugd/e91ac2_d361badc1a3346c8a9976a3713e83219.pdf

Source: press mat.