The association between patient attitudes and values with strength of consideration for contralateral prophylactic mastectomy in a population-based sample of breast cancer patients

Hawley, Sarah T.; Griffith, Kent A.; Hamilton, Ann S.; Ward, Kevin C.; Morrow, Monica; Janz, Nancy K.; Katz, Steven J.; Jagsi, Reshma

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The association between patient attitudes and values with strength of consideration for contralateral prophylactic mastectomy in a population-based sample of breast cancer patients

Published Date:

Aug 15 2017

Source:

Cancer. 123(23):4547-4555.

Language:

English

[PDF-542.32 KB]

Details:

Personal Authors:

Hawley, Sarah T. ; Griffith, Kent A. ; Hamilton, Ann S. ; Ward, Kevin C. ; Morrow, Monica ; ... More ▼

Keywords:

[+]

Pubmed ID:

28810062

Pubmed Central ID:

PMC5907487

Description:

Background

Little is known about how the individual decision styles and values of breast cancer patients at the time of treatment decision making are associated with consideration of different treatment options, specifically with consideration of contralateral prophylactic mastectomy (CPM).

Methods

We identified newly diagnosed patients with early-stage breast cancer treated in 2013–14, identified through SEER registries of Los Angeles & Georgia, and surveyed them about 7 months after surgery (N=2578, RR=71%). The primary outcome was consideration of CPM (strong vs. less strong). We assessed the association between patients’ values and decision styles and strong consideration using multivariable logistic regression.

Results

About one quarter (25%) of women reported strong/very strong consideration of CPM, and another 29% considered it moderately/weakly. Decision styles, including “rational-intuitive” approach to decision making, varied. The factors most valued by women at the time of treatment decision making were: avoiding worry about recurrence (82%), and reducing the need for more surgery (73%). In multivariable analysis, patients who preferred to make their own decisions, those who valued avoiding worry about recurrence, and who valued avoiding radiation significantly (P<0.05) more often strongly considered CPM, while those reported being more “logical” and who valued keeping their breast less often did so.

Conclusions

Many patients considered CPM, and consideration was associated with both decision style and values. The variability in decision style and values observed in this study suggests that formally evaluating these characteristics at or prior to the initial treatment encounter could provide an opportunity for improving patient clinician discussions.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

HHSN261201000140C/CA/NCI NIH HHS/United States
HHSN261201000035C/CA/NCI NIH HHS/United States
P30 CA046592/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

Place as Subject:

United States

Main Document Checksum:

[+]

Supporting Files:

	NIHMS894811-supplement-Supp_FigS1.tif	image/tiff
	nihms894811.nxml	text/xml
	nihms894811f1.gif	image/gif
	nihms894811f1.jpg	image/jpeg
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	nihms894811f2.jpg	image/jpeg

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