An exploratory cross-sectional survey of participating medical oncologists’ perceptions of biomarker testing utility and accessibility in breast cancer management in Benghazi, Libya

Background Biomarker testing plays an important role in characterising breast cancer and guiding treatment decisions, particularly through routinely used markers such as the oestrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67. Understanding medical oncologists’ perceptions of how these biomarkers are used in routine practice is essential for identifying gaps in accessibility and clinical application, especially in resource-limited settings such as Benghazi, Libya. Objective To assess medical oncologists’ perceptions of the utility, accessibility, and implementation barriers of biomarker testing in breast cancer treatment planning in Benghazi, Libya. Methods An exploratory cross-sectional, questionnaire-based study was conducted between 18 March and 12 April 2025 among 27 participating medical oncologists in Benghazi. An adapted structured questionnaire assessed demographic characteristics, biomarker use, perceived accessibility, and medical oncologists’ views on biomarker-informed treatment planning. Descriptive statistics and Fisher’s exact tests were used for data analysis. Results Of the 30 medical oncologists contacted, 27 participated. Most respondents (85.2%) rated biomarker testing as extremely important for guiding treatment decisions. The most frequently reported biomarkers used in routine practice were ER (92.6%), HER2 (88.9%), and PR (81.5%). Limited availability of testing centres (55.6%) and high cost (66.7%) were the most common perceived barriers. A majority (74.1%) stated that biomarker testing always influences treatment decisions. Expanding the number of testing centres (77.8%) and enhancing medical training on biomarker-based treatment (74.1%) were the most frequently selected suggested improvements. Conclusion Participating medical oncologists viewed biomarker testing as important for breast cancer treatment planning but reported barriers related particularly to cost and testing-centre availability. These exploratory findings reflect clinician perceptions and reported practice and should not be generalised beyond the surveyed group or interpreted as evidence of patient-level clinical outcomes. Larger studies incorporating objective service and patient-level data are needed.