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Thérapies ciblées chez les femmes atteintes de cancer du sein métastatique : diffusion, impact sur la prise en charge, poids des représentations sociales et adhésion thérapeutique

Abstract : In France, breast cancer is the most common cancer amongst women and the second cause of cancer death. Although breast cancer relative mortality has decreased significantly in recent years, there is still a lot to be done for the remaining 20% to 25% of patients who have metastasized. This study is based on 103 semi-structured interviews carried out with oncology healthcare professionals and metastatic breast cancer patients. The aim of this work was to study the impact that new targeted therapies can have on managing the patient’s care and their diffusion, the patients’ experiences with these treatments, their social representations and their therapeutic adherence. First, we showed that new oral targeted therapies disrupt the traditional steps in a patient care. Patients arefar less in the hospital’s sphere of influence and there are many barriers to the dissemination of these treatments for oncologists. Second, we highlighted the positive representations of oral targeted therapies that patients have, which is bringing them hope and improving their quality of life. However, the day-to-day experience with the treatment sometimes moderates these representations and may reveal obstacles to their therapeutic adherence such as side effects or the responsibilities created by the demand for autonomy. Finally, we showed the lack of patients’ knowledge about therapeutic innovations and the importance of the implementation of shared decision making with the oncologist, especially in the face of the progressive chronicisation of a number of metastatic breast cancers.
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https://tel.archives-ouvertes.fr/tel-01708546
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Submitted on : Tuesday, February 13, 2018 - 5:26:05 PM
Last modification on : Wednesday, October 14, 2020 - 4:00:25 AM
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Elise Martin. Thérapies ciblées chez les femmes atteintes de cancer du sein métastatique : diffusion, impact sur la prise en charge, poids des représentations sociales et adhésion thérapeutique. Santé publique et épidémiologie. Université Paris Saclay (COmUE), 2017. Français. ⟨NNT : 2017SACLS534⟩. ⟨tel-01708546⟩

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