From Policy To Patients And Back: Surgical Treatment Decision Making For Patients With Breast Cancer

2007 ◽  
Vol 26 (3) ◽  
pp. 761-769 ◽  
Author(s):  
Steven J. Katz ◽  
Sarah T. Hawley
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Treatment ◽  
Treatment Decision ◽  
Treatment Decision Making

Patient and surgeon correlates of shared decision making for surgical breast cancer treatment

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6031-6031
Author(s):  
S. Hawley ◽  
P. Lantz ◽  
B. Salem ◽  
A. Fagerlin ◽  
N. Janz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Treatment ◽  
Cancer Treatment ◽  
Treatment Decision ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Shared Decision ◽  
Treatment Decision Making ◽  
The Right

6031 Background: The choice of surgical breast cancer treatment represents an opportunity for shared decision making (SDM), since both mastectomy and breast conserving surgery are viable options. Yet women vary in their desire for involvement in this decision. Correlates of SDM and/or the level of involvement in breast cancer surgical treatment decision-making are not known. Methods: Breast cancer patients of Detroit and Los Angeles SEER registries were mailed a questionnaire shortly after diagnosis in 2002 (N = 1,800, RR: 77%). Their responses were merged with a surgeon survey (N = 456, RR: 80%) for a dataset of 1,547 patients of 318 surgeons. Surgical treatment decision making was categorized into: 1) surgeon-based; 2) shared; or 3) patient-based. The concordance between a woman’s self-reported actual and desired decisional involvement was categorized as having more, less, or the right amount of involvement. Decision making and concordance were each analyzed as three-level dependent variables using multinomial logistic regression controlling for clustering within surgeons. Independent variables included patient clinical, treatment and demographic factors, surgeon demographic and practice-related factors, and a measure of surgeon-patient communication. Results: 37% of women reported the surgery decision was shared, 25% that it was surgeon-based, and 38% that it was patient-based. Two-thirds experienced the right amount of involvement, while 13% had less and 19% had more. Compared to women who reported a shared decision, those with surgeon-based decision were significantly (p < 0.05) more likely to have male surgeons, and those reporting a patient-based decision were more likely to have received mastectomy vs. breast conserving surgery. Women who were less involved in the surgery decision than they wanted were younger and had less education, while those with more involvement (vs. the right amount) more often had male surgeons. Patient-surgeon communication was associated with decisional involvement. Conclusions: Correlates of SDM and decisional involvement relating to surgical breast cancer treatment differ. Determining patients’ desired role in decision making may as important as achieving a shared decision for evaluating perceived quality of care. No significant financial relationships to disclose.

scholarly journals Factors associated with patient involvement in surgical treatment decision making for breast cancer

2007 ◽  
Vol 65 (3) ◽  
pp. 387-395 ◽  
Author(s):  
Sarah T. Hawley ◽  
Paula M. Lantz ◽  
Nancy K. Janz ◽  
Barbara Salem ◽  
Monica Morrow ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Treatment ◽  
Patient Involvement ◽  
Treatment Decision ◽  
Factors Associated ◽  
Treatment Decision Making

Participation and Satisfaction with Surgical Treatment Decision-Making in Breast Cancer Among Chinese Women

2003 ◽  
Vol 80 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Wendy Lam ◽  
Richard Fielding ◽  
Miranda Chan ◽  
Louis Chow ◽  
Ella Ho
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Treatment ◽  
Chinese Women ◽  
Treatment Decision ◽  
Treatment Decision Making

Enhancing Involvement in Treatment Decision Making by Women with Breast Cancer

2007 ◽  
Author(s):  
Mary A. O'Brien ◽  
Timothy Whelan ◽  
Amiram Gafni ◽  
Cathy Charles ◽  
Peter Ellis
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Treatment Decision ◽  
Treatment Decision Making

Gene Expression Assay in the Management of Early Breast Cancer

2020 ◽  
Vol 27 (17) ◽  
pp. 2826-2839 ◽  
Author(s):  
Roberta Caputo ◽  
Daniela Cianniello ◽  
Antonio Giordano ◽  
Michela Piezzo ◽  
Maria Riemma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Decision Making ◽  
Adjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Treatment Decision ◽  
Endocrine Treatment ◽  
Expression Ratio ◽  
Treatment Decision Making ◽  
Low Sensitivity

The addition of adjuvant chemotherapy to hormonal therapy is often considered questionable in patients with estrogen receptor-positive early breast cancer. Low risk of disease relapse after endocrine treatment alone and/or a low sensitivity to chemotherapy are reasons behind not all patients benefit from chemotherapy. Most of the patients could be exposed to unnecessary treatment- related adverse events and health care costs when treatment decision-making is based only on classical clinical histological features. Gene expression profile has been developed to refine physician’s decision-making process and to tailor personalized treatment to patients. In particular, these tests are designed to spare patients the side effects of unnecessary treatment, and ensure that adjuvant chemotherapy is correctly recommended to patients with early breast cancer. In this review, we will discuss the main diagnostic tests and their potential clinical applications (Oncotype DX, MammaPrint, PAM50/Prosigna, EndoPredict, MapQuant Dx, IHC4, and Theros-Breast Cancer Gene Expression Ratio Assay).

Measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective

2013 ◽  
Vol 23 (3-4) ◽  
pp. 482-491 ◽  
Author(s):  
Liv-Helen Heggland ◽  
Aslaug Mikkelsen ◽  
Torvald Øgaard ◽  
Kjell Hausken
Keyword(s):  
Decision Making ◽  
Surgical Treatment ◽  
Patient Participation ◽  
Healthcare Professionals ◽  
Treatment Decision ◽  
Treatment Decision Making
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