PURPOSE: To explore the health-related and psychological factors that influence decision making about tamoxifen (Nolvadex; AstraZeneca, Waltham, MA) chemoprevention in women at increased risk for developing breast cancer. METHODS: This study involves the assessment of 129 women eligible to take tamoxifen following cancer-risk counseling. Treatment decision and decision satisfaction were measured at 2 and 4 months following counseling. Health-related factors included physician recommendation, personal and family-related health history, and concern about side effects. Psychological factors included breast cancer-related anxiety, risk perception, and depression. RESULTS: At 2 months' follow-up, 44% of participants declined tamoxifen treatment. This number increased to 49% at 4 months. Personal and family health history were not related to the decision, but history of abnormal biopsy did predict tamoxifen use. Physician recommendation was highly correlated with treatment decision. Concern about side effects was related to the decision to decline treatment. Breast cancer-related anxiety and heightened risk perception were associated with the decision to take tamoxifen. However, anxiety and psychological distress were also negatively related to treatment satisfaction. CONCLUSION: Decision-making about tamoxifen is complex, and many eligible women decline treatment or remain undecided. Findings call for further educational follow-up with high-risk women after they undergo initial counseling. Factors related to misperceptions of risk and side effects, as well as psychological distress, may be particularly important targets for intervention.
PURPOSE: To explore the health-related and psychological factors that influence decision making about tamoxifen (Nolvadex; AstraZeneca, Waltham, MA) chemoprevention in women at increased risk for developing breast cancer. METHODS: This study involves the assessment of 129 women eligible to take tamoxifen following cancer-risk counseling. Treatment decision and decision satisfaction were measured at 2 and 4 months following counseling. Health-related factors included physician recommendation, personal and family-related health history, and concern about side effects. Psychological factors included breast cancer-related anxiety, risk perception, and depression. RESULTS: At 2 months' follow-up, 44% of participants declined tamoxifen treatment. This number increased to 49% at 4 months. Personal and family health history were not related to the decision, but history of abnormal biopsy did predict tamoxifen use. Physician recommendation was highly correlated with treatment decision. Concern about side effects was related to the decision to decline treatment. Breast cancer-related anxiety and heightened risk perception were associated with the decision to take tamoxifen. However, anxiety and psychological distress were also negatively related to treatment satisfaction. CONCLUSION: Decision-making about tamoxifen is complex, and many eligible women decline treatment or remain undecided. Findings call for further educational follow-up with high-risk women after they undergo initial counseling. Factors related to misperceptions of risk and side effects, as well as psychological distress, may be particularly important targets for intervention.
Authors: Laura L Reimers; Parijatham S Sivasubramanian; Dawn Hershman; Mary Beth Terry; Heather Greenlee; Julie Campbell; Kevin Kalinsky; Matthew Maurer; Ramona Jayasena; Rossy Sandoval; Maria Alvarez; Katherine D Crew Journal: Breast J Date: 2015-04-16 Impact factor: 2.431
Authors: Celia Patricia Kaplan; Sue E Kim; Sabrina T Wong; George F Sawaya; Judith M E Walsh; Eliseo J Pérez-Stable Journal: Breast Cancer Res Treat Date: 2012-05 Impact factor: 4.872
Authors: Sarah B Blakeslee; Worta McCaskill-Stevens; Patricia A Parker; Christine M Gunn; Hanna Bandos; Therese B Bevers; Tracy A Battaglia; Angela Fagerlin; Jacqueline Müller-Nordhorn; Christine Holmberg Journal: Patient Educ Couns Date: 2017-06-27
Authors: Richard G Roetzheim; Ji-Hyun Lee; William Fulp; Elizabeth Matos Gomez; Elissa Clayton; Sharon Tollin; Nazanin Khakpour; Christine Laronga; Marie Catherine Lee; John V Kiluk Journal: Breast Date: 2014-12-06 Impact factor: 4.380
Authors: Angela Fagerlin; Brian J Zikmund-Fisher; Vijayan Nair; Holly A Derry; Jennifer B McClure; Sarah Greene; Azadeh Stark; Sharon Hensley Alford; Paula Lantz; Daniel F Hayes; Cheryl Wiese; Sarah Claud Zweig; Rosemarie Pitsch; Aleksandra Jankovic; Peter A Ubel Journal: Breast Cancer Res Treat Date: 2010-02 Impact factor: 4.872