Patients Desire Involvement in Planning Breast CA Treatment

Preferences shift to wanting more say in decisions following breast cancer treatment consultation

TUESDAY, Feb. 7 (HealthDay News) -- Many patients with early-stage breast cancer have a desire for decisional control, which increases postconsultation, and patients who are involved in decisions have better decision-related outcomes, according to a study published online Feb. 6 in the Journal of Clinical Oncology.

Richard Brown, Ph.D., of Virginia Commonwealth University in Richmond, and colleagues studied 683 patients with breast cancer from 62 oncologists in five different countries recruited to an International Breast Cancer Study Group project. Questionnaires were used to determine patients' pre- and postconsultation preferences for participation in treatment decision making and whether or not these preferences were met. After the consultation, decision-related outcomes were assessed.

The researchers found that most patients preferred shared or patient-directed treatment decision making before the consultation. Following the consultation, 43 percent of patients' preferences changed, and most moved toward patient-directed decisions. The actual treatment decision was more likely to be made in accordance with postconsultation preferences, rather than preconsultation preferences. Patients who were as involved as they had wanted to be or were more involved in making decisions had significantly better decision-related outcomes than patients who were less involved than they had hoped to be; this result was irrespective of whether there was a change in preference or not.

"Many patients with early-stage breast cancer have treatment options and approach treatment decisions with a desire for decisional control, which may increase after their consultation," the authors write. "Patients' ultimate involvement preferences were more likely to be consistent with the way the decision was actually made, suggesting that patients need to feel concordance between their preference and the actual decision."

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