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Discrepancy between preference and actual adjuvant therapy for breast cancer
Marie E Wood1, Teresa A Fama, Takamaru Ashikaga
1Department of Medicine, University of Vermont, Burlington, VT 05405. marie.wood@uvm.edu
Clinical Breast Cancer
|October 6, 2010
Summary
Most women with breast cancer did not receive their preferred adjuvant therapy after surgery. Less than half of patients received their initially preferred treatment, often receiving less aggressive options.
Area of Science:
- Oncology
- Medical Decision Making
- Patient Preferences
Background:
- Understanding patient preferences for adjuvant therapy is crucial in breast cancer care.
- Discrepancies between patient preferences and actual treatment received can impact outcomes and satisfaction.
Purpose of the Study:
- To compare pretreatment preferences for adjuvant therapy with the actual treatment received in women with node-negative breast cancer.
- To explore the relationship between risk of recurrence and treatment aggressiveness in patient preferences and outcomes.
Main Methods:
- Prospective study involving 75 women with node-negative breast cancer before definitive surgery.
- Patients indicated adjuvant therapy preferences based on clinical scenarios with varying risk/benefit information.
- Statistical analyses included contingency tables, Spearman rank correlation, Kruskal-Wallis, and Friedman rank sum tests.
Main Results:
- A significant correlation was found between the risk of recurrence and preferred treatment aggressiveness (P < .001).
- The high-risk group received more aggressive treatment post-surgery than the low-risk group (P = .004).
- Only 45% of women received their preferred therapy; most (P = .0002) received less aggressive treatment than preferred.
Conclusions:
- This study highlights a significant gap between patient preferences and actual adjuvant therapy received in breast cancer.
- Less than half of women achieved their desired treatment intensity, with a trend towards less aggressive therapy.
- Further research is needed to understand and address this discrepancy in breast cancer treatment decision-making.
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