RNS: Breast cancer treatment options, July 30, 2008
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U-M Health Minute: Today’s top health issues and medical research
Minorities less likely to know about breast cancer treatment options, U-M researchers find
Half of patients don’t know how survival differs between surgical options
Suggested lead: A new study from the University of Michigan Comprehensive Cancer Center reveals that minority women with breast cancer are often making treatment decisions without knowing some very important information – including their survival odds. Here’s Andi McDonnell with more.
Nearly half of women treated for breast cancer did not know that their odds of being alive after five years are roughly the same - whether they undergo mastectomy or breast conserving surgery.
Minority women were even less likely to be aware of this important factor of their treatment decision, according to a study from the University of Michigan Comprehensive Cancer Center.
Study author Dr. Sarah Hawley, (Ph.D.), a research investigator at the U-M Comprehensive Cancer Center, tells us…
“Our results suggested that again, we found low knowledge among women who’d been through the treatment decision-making process across all racial ethnic groups, but we found particular deficits in African American and Latina patients. We also showed that these factors traditionally associated with quality care were not associated with informed decision making or with our knowledge measures. So surgeon volume or treatment setting did not effect whether or not women had good knowledge of their treatment options after they’d been through the process, nor did it really mediate the racial ethnic differences that we found. A positive finding though was that across women, if they reported that their surgeon discussed the treatment options with them they were much more likely to have better knowledge about these options. .”
The researchers surveyed 1,132 breast cancer patients and asked them whether the chances of being alive five years after surgery were the same after a mastectomy or after lumpectomy with radiation. They also asked whether the chance of breast cancer coming back after treatment was the same for the two surgeries.
Overall, only 51 percent responded correctly to the survival question. However, the numbers varied significantly for minorities: 57 percent of whites answered correctly, 34 percent of African-Americans knew their survival odds, and 37 percent of Latinas did.
The study also demonstrated the same disparities, regardless of where a patient received care. This finding, Hawley say, was somewhat surprising …
“We expected that some of the factors traditionally associated with quality care might be associated with knowledge or informed decision-making among women who went through the treatment decision making process, only because higher volume surgeons may have more experience in discussing the treatment options and NCI Comprehensive Cancer Centers may have a more multidisciplinary approach and have more materials available to patients, however, we didn’t find that to be the case in this particular analysis.”
The researchers urge surgeons to make sure they are providing adequate information about treatment options, including survival and recurrence risks, during the initial visit in a way that is culturally and ethnically appropriate. At the same time, patients must be aware of their surgical treatment options and fully understand the risks and benefits of both options.
Hawley tells us…
“Our team here at the University of Michigan feels that it’s really important for women to be able to do what we call a high quality decision-making process, so that would mean that the decision needs to be well informed, based on an accurate knowledge of the risks and benefits of the options and also needs to be based on their preferences. So if women do not make an informed decision or have a high quality decision then they’re more likely to be dissatisfied down the road with what they received.”
Andi McDonnell, U-M Health System News
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