#3107 Purpose: To examine factors associated with seeking second opinions, patient satisfaction, and education among a recently diagnosed internet-based breast cancer population. Methods: In 2007, 6970 of the 90,426 internet-registered female breast cancer patients completed an internet-based survey, developed jointly by members of the Department of Surgical Oncology at Emory University and the educational staff at the Healthcare business of Thomson Reuters, formerly Nexcura. After excluding caregivers (n=205), those not within 5 years of diagnosis (n=962) or for whom treatment information was missing (n=40), we analyzed 5763 patients. Chi-square tests were used to assess system characteristics and patient demographics by their second opinion, satisfaction, and informed status. Patient satisfaction was collapsed as low (1-3), moderate (4-6), or high (7-10). How informed patients considered themselves was combined into 3 categories: well-informed (well or very well informed), somewhat informed and uninformed (somewhat or very uninformed). Results: The majority of the 5763 patients were between ages 40 and 59 when diagnosed (75.43%), Caucasian (92.96%), currently married (76.33%), had a household income ≥ $50,000 (60.92%) and at least a 4-year college education (55.78%). Stage I and II cancers comprised 36.61 and 35.71% respectively. Over one-third (n=2039) sought a second opinion. Factors significantly associated with seeking a second opinion were higher socioeconomic or education status, feeling informed, receiving the initial diagnosis from a primary care physician or private community hospital, close proximity to the biopsy location, and less satisfaction with the initial biopsy experience. Patients highly satisfied with their second opinion (87.35%) were more likely to refer others (96.52%), use the second opinion facility for the next treatment (63.90%), and to not seek additional opinions (75.29%). Facility options and initially being treated with surgery or systemic therapy predicted high satisfaction with initial treatment. Medical oncologists were the most frequently cited primary source of breast cancer education (37.81%), followed by surgeons (30.57%), and the internet (12.77%). About 20% who cited these sources considered themselves somewhat or very uninformed. Conclusions: Women who seek information via the internet rely primarily on medical professionals for their breast cancer education. Factors related to the initial biopsy affect the likelihood of patients seeking a second opinion, satisfaction with second opinions can influence choices regarding the ensuing treatment steps, and factors associated with initial treatment influence patient satisfaction. Probing the issues underlying these findings could improve care for all. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3107.
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