Interpersonal influences and attitudes about adjuvant therapy treatment decisions among non-metastatic breast cancer patients: An examination of differences by age and race/ethnicity in the BQUAL study

Rachel C. Shelton, Grace Clarke Hillyer, Dawn L. Hershman, Nicole Leoce, Dana H. Bovbjerg, Jeanne S. Mandelblatt, Lawrence H. Kushi, Lois Lamerato, S. David Nathanson, Christine B. Ambrosone, Alfred I. Neugut

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Patients are increasingly involved in cancer treatment decisions and yet little research has explored factors that may affect patient attitudes and beliefs about their therapeutic choices. This paper examines psychosocial factors (e.g., attitudes, social support), provider-related factors (e.g., communication, trust), and treatment considerations in a prospective study of a sample of non-metastatic breast cancer patients eligible for chemotherapy and/or hormonal therapy (BQUAL cohort). The data come from a multisite cohort study of white, black, Hispanic, and Asian non-metastatic breast cancer patients recruited in New York City, Northern California, and Detroit, Michigan. Baseline surveys were conducted over the telephone between 2006 and 2010 among a total of 1,145 women. Most participants were white (69 %), had more than a high school education (76 %), and were diagnosed with stage I disease (51 %). The majority of women reported discussing chemotherapy and hormonal therapy with their doctor (90 and 83 %, respectively); these discussions primarily took place with medical oncologists. Nearly a quarter of women reported that the treatment decision was difficult, and the majority were accompanied to the doctor (76 %) and involved a friend or family member in making the decision (54 %). Positive considerations (e.g., beliefs about treatment reducing risk of recurrence) were important in making treatment decisions. Participants preferred a shared decision-making style, but results suggested that there is room for improvement in terms of actual patient's involvement in making the decision and provider communication, particularly among black patients. Patients 65 years and older reported fewer provider discussions of chemotherapy, poorer patient-provider communication, higher rates of being assisted by family members in making the decision, and more negative attitudes and beliefs toward treatment.

Original languageEnglish (US)
Pages (from-to)817-828
Number of pages12
JournalBreast Cancer Research and Treatment
Volume137
Issue number3
DOIs
StatePublished - Feb 2013
Externally publishedYes

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Breast Neoplasms
Decision Making
Therapeutics
Communication
Drug Therapy
Patient Participation
Hispanic Americans
Telephone
Social Support
Cohort Studies
Prospective Studies
Psychology
Education
Recurrence
Research
Neoplasms

Keywords

  • Adjuvant therapy
  • Age
  • Breast cancer
  • Quality of care
  • Racial disparities
  • Treatment decisions

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Interpersonal influences and attitudes about adjuvant therapy treatment decisions among non-metastatic breast cancer patients : An examination of differences by age and race/ethnicity in the BQUAL study. / Shelton, Rachel C.; Hillyer, Grace Clarke; Hershman, Dawn L.; Leoce, Nicole; Bovbjerg, Dana H.; Mandelblatt, Jeanne S.; Kushi, Lawrence H.; Lamerato, Lois; David Nathanson, S.; Ambrosone, Christine B.; Neugut, Alfred I.

In: Breast Cancer Research and Treatment, Vol. 137, No. 3, 02.2013, p. 817-828.

Research output: Contribution to journalArticle

Shelton, RC, Hillyer, GC, Hershman, DL, Leoce, N, Bovbjerg, DH, Mandelblatt, JS, Kushi, LH, Lamerato, L, David Nathanson, S, Ambrosone, CB & Neugut, AI 2013, 'Interpersonal influences and attitudes about adjuvant therapy treatment decisions among non-metastatic breast cancer patients: An examination of differences by age and race/ethnicity in the BQUAL study', Breast Cancer Research and Treatment, vol. 137, no. 3, pp. 817-828. https://doi.org/10.1007/s10549-012-2370-4
Shelton, Rachel C. ; Hillyer, Grace Clarke ; Hershman, Dawn L. ; Leoce, Nicole ; Bovbjerg, Dana H. ; Mandelblatt, Jeanne S. ; Kushi, Lawrence H. ; Lamerato, Lois ; David Nathanson, S. ; Ambrosone, Christine B. ; Neugut, Alfred I. / Interpersonal influences and attitudes about adjuvant therapy treatment decisions among non-metastatic breast cancer patients : An examination of differences by age and race/ethnicity in the BQUAL study. In: Breast Cancer Research and Treatment. 2013 ; Vol. 137, No. 3. pp. 817-828.
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