28004220

PMC5310669

Purpose

Little is known about different ways of assessing risk of distant recurrence following cancer treatment (e.g., numeric or descriptive). We sought to evaluate the association between overestimation of risk of distant recurrence of breast cancer and key patient reported outcomes, including quality of life and worry.

Methods

We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer identified through SEER registries of Los Angeles & Georgia (2013-14) ∼2 months after surgery (N=2578, RR=71%). Actual 10-year risk of distant recurrence after treatment was based on clinical factors for women with DCIS & low risk invasive cancer (Stg 1A, ER+HER2-, Gr 1-2). Women reported perceptions of their risk numerically (0 – 100%), with values ≥10% for DCIS & ≥20% for invasive considered overestimates. Perceptions of “moderate, high or very high” risk were considered descriptive overestimates. In our analytic sample (N=927), we assessed factors correlated with both types of overestimation and report multivariable associations between overestimation and QoL (PROMIS physical & mental health) and frequent worry.

Results

30.4% of women substantially overestimated their risk of distant recurrence numerically and 14.7% descriptively. Few factors other than family history were significantly associated with either type of overestimation. Both types of overestimation were significantly associated with frequent worry, and lower QoL.

Conclusions

Ensuring understanding of systemic recurrence risk, particularly among patients with favorable prognosis, is important. Better risk communication by clinicians may translate to better risk comprehension among patients and to improvements in QoL.

CDC Public Access

HHSN261201000035C/PC,CA/None/None
HHSN261201000140C/CA/NCI NIH HHS/United States
P01 CA163233/CA/NCI NIH HHS/United States
U58 DP003875/DP/NCCDPHP CDC HHS/United States
HHSN261201300015C/RC/CCR NIH HHS/United States
HHSN261201000035I/CA/NCI NIH HHS/United States
HHSN261201000034C/CA/NCI NIH HHS/United States
U58 DP003862/DP/NCCDPHP CDC HHS/United States