Details:

Alternative Title:
Cancer
Personal Author:
Hawley, Sarah T. ; Griffith, Kent A. ; Hamilton, Ann S. ; Ward, Kevin C. ; Morrow, Monica ; ... More +
Hawley, Sarah T. ; Griffith, Kent A. ; Hamilton, Ann S. ; Ward, Kevin C. ; Morrow, Monica ; Janz, Nancy K. ; Katz, Steven J. ; Jagsi, Reshma ; Less -
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.
Subject:
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Adult
Aged
Article
Breast Cancer
Breast Neoplasms
Contralateral Prophylactic Mastectomy
Decision-making
Decision Making
Decision Styles
Female
Follow-Up Studies
Health Knowledge, Attitudes, Practice
Humans
Insurance, Health
Middle Aged
Neoplasm Staging
Population-based Survey
Prognosis
Prophylactic Mastectomy
SEER Program
Surveys And Questionnaires
Women
Young Adult

Source:
Cancer. 123(23):4547-4555.
Pubmed ID:
28810062
Pubmed Central ID:
PMC5907487
Document Type:
Journal Article ;
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 ; ... More +
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 ; Less -
Place as Subject:
United States ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:08b325d4de8ef29c17d878124d5ebac0bee7d6059faaf9f9be882886fa060566
File Type:

Supporting Files

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