Treatment decision making in women newly diagnosed with breast cancer

Abstract

The purpose of this study was to explore the hypothesis that women with breast cancer had specific preferences about the degree of control they wanted over treatment decision making. One hundred fifty women, newly diagnosed with breast cancer, were interviewed and their preferences for participation in treatment decision making were established using a measurement tool designed to elicit decision-making preferences (Degner LF, Sloan JF. Decision making during serious illness: What role do patients really want to play? J Clin Epidemiol 1992;45:944-50). Two hundred women with benign breast disease served as a descriptive comparison group. Unfolding theory (Coombs CH. A theory of data. New York: John Wiley & Sons, 1964) provided a means of analyzing the data so that the degree of control preferred by each woman could be established. The majority of the newly diagnosed women preferred to play a passive role in treatment decision making, leaving the decision-making responsibility to their physician, whereas the benign control group preferred a collaborative role in which joint decisions could be made between the patient and the physician. The implications of the results for patient participation are discussed.

The Meaning of Breast Cancer

“…(7)). This result is perhaps due to cultural differences with, as reported earlier, more active breast cancer patients regarding preferred patient roles in Canada and Great Britain (4,5).…”

Collaborative/active participationper se does not decrease anxiety in breast cancer

“…1,[6][7][8][9][10][11][12][13][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The patients' expectations also depend on the type of the disease, 15,20 or the type of the malignancy. 13,15,19,25 Most of the literature data on the attitude of breast cancer patients towards being informed, and participation in treatment decision come from Canada, 15,17,18,26,32 the US, 7,10,25,[27][28][29][30][31]34 Australia, 6,9,…”

The context influences doctors' support of shared decision-making in cancer care

“…Breast and urological cancer doctors believe more of their patients wish to be involved in decision-making. Indeed, studies that have investigated the information and involvement preferences of patients demonstrate that breast cancer patients prefer a more active role than other cancer patients (Beaver et al, 1996;Degner et al, 1997;Bruera et al, 2002).…”