Navigation Links
Early-stage breast cancer patients lack knowledge; may not receive treatment they prefer

CHICAGO (January 10, 2012) According to the results of a new study published in the January 2012 issue of the Journal of the American College of Surgeons, many early-stage breast cancer survivors lacked knowledge about their disease and were not meaningfully involved in treatment discussions or asked their preferences regarding the approach to treatment. As a result, the study's investigators determined that there is a need for improvements in the quality of the surgical decision-making process for these patients.

The retrospective study sought to evaluate the quality of the decision-making process regarding the options for surgical treatment. The "quality" for early-stage breast cancer patients in this study was defined as the degree to which a decision was informed and consistent with patient preferences. Although several other studies have found knowledge gaps and identified specific patient concerns that affect decisions about breast cancer surgery,i ii iii this is the first study that attempted to examine how often treatments actually reflect patient preferences.

Surveys were mailed to adult women with a history of early-stage invasive breast cancer (stages I and II) treated at one of four academic medical centers: The Dana-Farber Cancer Institute, Boston; Massachusetts General Hospital, Boston; University of California, San Francisco; and University of North Carolina, Chapel Hill. Patients answered about half of the questions right (average knowledge score was 52.7 percent), indicating some large gaps in knowledge for information that providers identified as critical. Less than half (48.6 percent) of study participants reported that their surgeon asked them about their preference regarding surgical treatment.

The data was collected an average of two-and-a-half years following the surgical procedure and recognized the fact that patients are likely to forget some information over time. However, the knowledge gaps concerned not just detailed information but also basic general concepts. For example, only half of the surveyed patients knew that the survival rate was the same for breast-conservation therapy and mastectomy. In addition, women who had a partial mastectomy were less knowledgeable about local recurrence rates than were women who had a mastectomy.

"This finding was concerning because patients who opt for partial mastectomy need to be aware of their slightly higher risk of local recurrence," said Clara N. Lee, MD, MPP, FACS, lead author of the study and an associate professor and director of surgical research at the University of North Carolina School of Medicine in Chapel Hill. "Patients and providers need to have transparent conversations about treatment options, risks and goals in order to make fully informed decisions."

The study stated that improving the quality of decisions about breast cancer surgery will require interventions to enhance patient knowledge and incorporate preferences into the decision-making process. "Two things are needed to help improve the quality of decisions. First, it is important to have a way to measure decision quality so that providers can get feedback on how they are doing. Second, we need to use decision tools that have been proven to inform and engage patients, more consistently," added Karen Sepucha, PhD, senior study author, assistant professor at Harvard Medical School and director of the Health Decision Sciences Center at Massachusetts General Hospital.

Of the 746 patients identified in the study, 440 participated (59 percent). The data showed that 45.9 percent of respondents knew that local recurrence risk is higher after breast conservation and 55.7 percent knew that survival is equivalent for the two options. Participants reported more frequent discussion of partial mastectomy and its advantages than of mastectomy, and 83.2 percent reported the provider made a treatment recommendation.

The survey included 10 multiple-choice questions regarding breast cancer knowledge, including treatment options, local recurrence, survival and side effects six items that were rated on a scale from 0 (not at all important) to 10 (extremely important) in the goals and concerns category and an additional seven multiple-choice items about the content of discussions with providers and how involved the patient was in the decision-making process. The decision about the type of surgical procedure for early-stage breast cancer is considered a "preference-sensitive" decision. Patients in this study were clinically eligible for either option, and an international consensus process has defined the quality of decision-making as the degree to which a decision is informed and concordant with patient preferences.iv v vi


Contact: Sally Garneski
Weber Shandwick Worldwide

Related medicine news :

1. Researchers find malignancy-risk gene signature for early-stage non-small cell lung cancer
2. More surgery in early-stage laryngeal cancer treatment; more chemoradiation for advanced-stage
3. Hidden cancer cells not a factor in early-stage breast cancer survival rates
4. Early-stage melanoma tumors contain clues to metastatic potential
5. UBC researchers to lead $4.7-million study on early-stage oral cancer
6. Protein test detects early-stage, asbestos-related pulmonary cancer
7. New test detects early-stage, asbestos-related pulmonary cancer
8. Voice-saver: Light therapy for early-stage laryngeal cancer
9. Benefit of brachytherapy in patients with early-stage prostate cancer is still unclear
10. Circulating tumor cells predicted recurrence, death in patients with early-stage breast cancer
11. Proton therapy safe, effective for early-stage lung cancer patients
Post Your Comments:
(Date:6/26/2016)... ... 26, 2016 , ... PawPaws brand pet supplements owned by Whole ... enhance the health of felines. The formula is all-natural and is made from Chinese ... PawPaws Cat Kidney Support Supplement Soft Chews are Astragalus Root Extract and ...
(Date:6/25/2016)... ... ... Austin residents seeking Mohs surgery services, can now turn to Dr. Jessica ... Peckham for medical and surgical dermatology. , Dr. Dorsey brings specialization to include Mohs ... Mohs Micrographic Surgery completed by Dr. Dorsey was under the direction of Glenn Goldstein, ...
(Date:6/25/2016)... ... , ... As a lifelong Southern Californian, Dr. Omkar Marathe earned his Bachelors ... Geffen School of Medicine at UCLA. He trained in Internal Medicine at Scripps Green ... hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the opportunity to train ...
(Date:6/24/2016)... , ... June 24, 2016 , ... A recent ... most people are unfamiliar with. The article goes on to state that individuals are ... many of these less common operations such as calf and cheek reduction. The Los ...
(Date:6/24/2016)... ... 24, 2016 , ... The Pulmonary Hypertension Association (PHA) learned ... receive two significant new grants to support its work to advance research and ... by recognizing patients, medical professionals and scientists for their work in fighting pulmonary ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the addition of ... Forecast to 2022" report to their offering. ... date financial data derived from varied research sources to present ... impact on the market during the next five years, including ... sub markets, regional and country level analysis. The report provides ...
(Date:6/23/2016)... PARK RIDGE, Ill. and INDIANAPOLIS ... caliber of students receiving a Lilly Diabetes Tomorrow,s Leaders ... hands. The 2016 scholarship winners, announced today online at ... refused to let type 1 diabetes stand in the ... Lilly Diabetes has supported the Foundation,s scholarship program since ...
(Date:6/23/2016)... -- Research and Markets has announced the ... (United States, China, Japan, Brazil, United Kingdom, Germany, France, ... Surgical Procedure Volumes: ... provides surgical procedure volume data in a geographic context. ... analysis of growth drivers and inhibitors, including world population ...
Breaking Medicine Technology: