scholarly journals Prevalence and Impact of Variants of Uncertain Significance on Local Therapy Decision-Making in Newly Diagnosed Breast Cancer Patients

2017 ◽  
Vol 99 (2) ◽  
pp. E2
Author(s):  
A.Y. Ho ◽  
K. Amoroso ◽  
M. Wilgucki ◽  
K. Vora ◽  
B.B. Arnold ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Local Therapy ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Variants Of Uncertain Significance ◽  
Therapy Decision ◽  
Uncertain Significance

Primary care provider-reported participation in breast cancer treatment decision making.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 78-78
Author(s):  
Lauren P. Wallner ◽  
Yun Li ◽  
Chandler McLeod ◽  
Archana Radhakrishnan ◽  
Sarah T. Hawley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Early Stage ◽  
Treatment Decision ◽  
Breast Cancer Treatment ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Treatment Decision Making

78 Background: Surgical treatment decisions for early-stage breast cancer patients are complex and often involve discussions with multiple oncology providers. However, with the increasing adoption of team-based cancer care models, it remains unknown to what extent primary care providers (PCPs) are participating in breast cancer treatment decisions and whether they feel they have enough knowledge to participate in these decisions effectively. Methods: A stratified random sample of PCPs identified by newly diagnosed early-stage breast cancer patients who participated in iCanCare Study (Georgia and Los Angeles SEER registries) were surveyed about their experiences caring for cancer patients (N = 519, 58% current response rate). PCPs were asked how frequently they discussed which surgery a patient should have, how comfortable they were with these discussions, whether they had the necessary knowledge to participate in treatment decision making and their confidence in their ability to help with treatment decision making (5-item likert-type scales). The individual items were then categorized as somewhat/often/always vs. never/rarely for analyses. Results: In this preliminary sample, 62% of PCPs were not comfortable having a discussion about surgery options with a patient newly diagnosed with breast cancer, 41% did not feel that they had the necessary knowledge to participate in treatment decision-making, and 34% were not confident in the ability to help with treatment decision-making. One third (32%) of PCPs reported discussing surgical treatment options with their newly diagnosed breast cancer patients, but 22% of these PCPs also reported that they were not comfortable having these discussions and 16% reported they did not have necessary knowledge to participate in decision-making. Conclusions: A minority of PCPs participate in breast cancer treatment decision-making and there are notable gaps in their self-reported knowledge about decision-making and confidence in their ability to help with these decisions. Efforts to increase PCP knowledge about the specifics of cancer treatments may be warranted, but further research is needed to assess the impact of PCP participation on treatment decision-making outcomes.

Surgical decision making for breast cancer: Treatment preferences prior to surgery.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 71-71 ◽  
Author(s):  
Katharine Yao ◽  
Kristen Wroblewski ◽  
Martha Van Haitsma ◽  
Sarah Rabbitt ◽  
Jordan Williams ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Prophylactic Mastectomy ◽  
Treatment Preference ◽  
Diagnostic Process ◽  
Treatment Preferences ◽  
Newly Diagnosed ◽  
Breast Cancer Patients

71 Background: Contralateral prophylactic mastectomy (CPM) rates are increasing but it is unclear how many patients consider CPM prior to their surgery. Methods: We developed a 55 item survey validated with 20 breast cancer survivors which was administered to newly diagnosed breast cancer patients (n=136) at two institutions prior to surgery to determine factors associated with CPM treatment preference. Results: The median age was 58 years (range 30-85). Eighty-three (69.2%) were White. Thirty-eight (28.6%) of patients had a 1st degree relative with breast cancer. Fifty-three patients (39.8%) thought about their surgery choice prior to getting breast cancer. Seventy-four (57.8%) of patients considered undergoing a CPM during decision making process, 31 (24.2%) did not want/consider CPM and 23 (18.0%) did not think CPM was an option. Of the 74 women who considered CPM, 12 (16%) chose CPM. Nearly 70% of women who considered CPM felt that CPM reduced the chance that cancer would come back vs 43.3% of women who did not want/consider CPM (p=0.02) and 86% of women who considered CPM stated that lumpectomy and mastectomy patients have equivalent survival compared to 100% of patients who did not want/consider CPM (p=0.03). Women who considered CPM were more likely to rate the diagnostic process as very/extremely emotionally difficult (47.3% vs 22.6%, p=0.03) and to state that being diagnosed with breast cancer “sent them into a daze” than those not wanting/considering a CPM (37.5% vs 13.3%, p=0.02). Likewise, women considering CPM had higher rates of anxiety (49.3% vs 12.9%, p<0.001) and depression (19.7% vs 3.2%, p=0.03); were more likely to be very/extremely worried about getting cancer elsewhere in their body (43.8% vs 6.5%, p<0.001) and very/extremely worried about how a spouse/partner would feel about their changed body than those women who did not want/consider CPM (18.5% vs 0%, p=0.03). Women who did not think CPM was an option were older (p=0.02), less educated (p=0.05), more often single (p=0.05). Conclusions: Over 50% of newly diagnosed breast cancer patients consider CPM prior to their surgery. Women considering a CPM had greater worry about recurrence, higher anxiety levels and less knowledge than patients not wanting/considering CPM.

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