Navigation Links
Confusing risk information may lead breast cancer patients to make poor treatment choices
Date:12/8/2008

ANN ARBOR, Mich. A new study from researchers at the University of Michigan Comprehensive Cancer Center found that a tool commonly used by doctors to estimate the risk of a woman's breast cancer returning after surgery is not very effective at explaining risk to patients. As a result, women with breast cancer may not find these tools helpful when deciding whether to have chemotherapy.

The tool itself is very useful to doctors, many of whom print out information from this tool and give it to patients when they are discussing chemotherapy. Nearly all women diagnosed with early stage breast cancer will have surgery, but many will also consider chemotherapy to help prevent the cancer from coming back.

"The main benefit of additional treatments such as chemotherapy after surgery is long-term risk reduction. But chemotherapy does not provide much benefit for some women, and those women can potentially avoid unnecessary side effects by skipping chemotherapy. So understanding how large or small the risk reduction is can help women make the right choice," says lead study author Brian Zikmund-Fisher, Ph.D., research assistant professor of general medicine at the U-M Medical School and a researcher at the VA Ann Arbor Healthcare System.

The currently available risk-assessment tools present risk statistics in a bar graph format that compares four different potential choices: hormonal therapy alone, chemotherapy alone, both hormonal and chemotherapy, or no treatment at all. The problem, Zikmund-Fisher points out, is that most women are really only choosing between two options: For women whose cancers are sensitive to the hormone estrogen, hormonal treatments provide large benefits with few side effects. The real question is whether chemotherapy is also necessary.

Because the tool shows statistics about all four options, however, the researchers found that it is more difficult for women to find and focus on the number that most matters to their choice: the benefit of adding chemotherapy to hormonal therapy.

In the study, published Dec. 15 in the journal Cancer, researchers surveyed 1,619 women, presenting them with a hypothetical breast cancer diagnosis. All women were given identical risk factors for recurrence. The women viewed one of four graphical formats to describe how chemotherapy would reduce the risk of dying from a return of cancer.

When respondents saw the risk information in the bar graph format that current risk-assessment tools use, only 51 percent correctly understood how much their chance of surviving would increase if they took chemotherapy. When women were shown a simpler graph that showed only the two key options, 65 percent were accurate. And, when the simpler graph used a pictograph format that showed a set of 100 small rectangles to represent the possible outcomes, a full 77 percent were able to correctly report the benefit of chemotherapy.

"Even when patients are given the information they need, they have to be able to understand it well enough to make the right choice. We're making patients work too hard. Discussions of risk need to be simple and transparent so doctors can spend as little time as possible explaining the numbers to patients and as much time as possible talking about what those numbers mean. That's the best way to make sure that each patient can make the right choice for her situation," says Zikmund-Fisher, a member of the Center for Behavioral and Decision Sciences in Medicine at U-M.

The researchers hope that eventually these risk tools will incorporate better ways to show these risks to both doctors and patients. In the meantime, Zikmund-Fisher suggests that patients confused about risk information think of it in terms of frequency, rather than percentages. In other words, if you are told you have an 82 percent chance of surviving 10 years, imagine there are 100 people just like you and that 82 of them are still alive to come back to a 10-year reunion.

"Thinking about those different people and what happens to each of them will help you to realize both possible outcomes and how likely each one is," Zikmund-Fisher says.


'/>"/>

Contact: Nicole Fawcett
nfawcett@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

Related medicine news :

1. IOM workshop on less confusing drug labeling, Oct. 12
2. Videoconferencing more confusing for decision-makers than face-to-face meetings
3. Informational handout key to giving parents a better understanding of CT radiation risks
4. HIV denialists spread misinformation online -- consequences could be deadly; and more
5. One of the Largest Post-WHI Physician Surveys Shows More Education is Needed: Patient Misinformation About Hormone Therapy Remains High
6. Justice Department to Hold Media Event to Demonstrate New Database for Matching Unidentified Remains and Missing Persons Information
7. Crystal Research Associates, LLC Issues Executive Informational Overview(R) (EIO(R)) on Tapestry Pharmaceuticals, Inc.
8. MEDEX Global Group & Harvard Medical International Join Forces to Create the Most Comprehensive Health Information Resource for International Travelers
9. Cities Say Restaurant Nutrition Information Crucial in Fighting Obesity
10. Metropolitan Hosts Informational Meetings in Nassau County
11. Health IT Now! Coalition Urges Congress to Pass Health Information Technology Bill This Year
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/9/2016)... ... December 09, 2016 , ... The Pennsylvania Athletic Trainers’ ... during the summer of 2016. The program was made possible by a Pennsylvania ... Department of Health and Human Services Administration. The broadcast, Use Your Head: ...
(Date:12/8/2016)... ... December 08, 2016 , ... Russ DiGilio ... the first national #QuackGivesBack campaign which supported local breast cancer organizations during National ... Quack Gives Back initiative, and we’re very pleased with the participation ...
(Date:12/8/2016)... ... December 08, 2016 , ... CURE Media Group, the ... advocacy groups, has aligned with Upstage Lung Cancer in efforts to combat lung cancer, ... Michael J. Hennessy, Jr said, “CURE Media Group is honored to team up with ...
(Date:12/8/2016)... Fla (PRWEB) , ... December 08, 2016 , ... ... smarter modes of access for customers and employees that are both engaging and ... 7 with Service Smart Technology, the software company revealed today its plans to ...
(Date:12/8/2016)... ... December 08, 2016 , ... STAT courier is pleased to announce ... service for Texas, they are expanding their presence in Dallas. One of the most ... will bring new jobs to the Dallas and Forth Worth market. STAT takes pride ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... 2016 Australia Glaucoma Surgery Devices Market ... report, "Australia Glaucoma Surgery Devices Market Outlook to ... Glaucoma Surgery Devices market. The report provides value, ... and average prices (USD) within market segement - ... company shares and distribution shares data for each ...
(Date:12/8/2016)... 8, 2016 Global Interventional Radiology Market: ... global interventional radiology market analyzes the current and ... an elaborate executive summary, including a market snapshot ... sub-segments. The research is a combination of ... bulk of our research efforts along with information ...
(Date:12/8/2016)... 8, 2016  Diplomat Pharmacy, Inc. (NYSE: DPLO) has been recognized ... Top Workplaces National Standard. To learn more about ... ... Inc.) ... survey administered by WorkplaceDynamics, LLC, a research firm specializing in organizational ...
Breaking Medicine Technology: