BACKGROUND: Decisions about adjuvant chemotherapy in older women with early stage breast cancer (EBC) are often challenging. Uncertainty about benefits due to limited data about treatment efficacy and outcomes complicates decision making. This qualitative study explored older patients' experiences and preferences towards information giving and ultimate decisions about adjuvant chemotherapy. METHODS: Clinicians from 24 UK breast cancer teams reported on adjuvant chemotherapy decisions for women aged ≥70 years with EBC from April 2010 to December 2011. Women who were offered chemotherapy were invited to participate in structured interviews. Self-reported quality of life (QoL) and functional ability were assessed. Qualitative methods were used to identify themes associated with information giving and decision making. RESULTS: A total of 58/95 eligible women (61%) participated. Median age was 73 years (range 70-83). Mean total scores for QoL and functional ability were average. The majority of women preferred to make their treatment decisions collaboratively with a clinician (59%) or on their own (19%). The main reasons influencing decisions to accept chemotherapy were categorised as prevention of recurrence and clinician recommendation. Side effects, length of treatment, impact on QoL, low survival benefits and clinician recommendation influenced decisions to decline chemotherapy. The majority (80%) were satisfied with information provision, the communication with their clinician and explanation of treatment. CONCLUSIONS: Older women with EBC preferred to be involved in clinical decision making. Clinician recommendation plays a significant role in either accepting or declining chemotherapy. Well-informed decision making and effective communication between clinicians, older women and their family members are therefore important.
BACKGROUND: Decisions about adjuvant chemotherapy in older women with early stage breast cancer (EBC) are often challenging. Uncertainty about benefits due to limited data about treatment efficacy and outcomes complicates decision making. This qualitative study explored older patients' experiences and preferences towards information giving and ultimate decisions about adjuvant chemotherapy. METHODS: Clinicians from 24 UK breast cancer teams reported on adjuvant chemotherapy decisions for women aged ≥70 years with EBC from April 2010 to December 2011. Women who were offered chemotherapy were invited to participate in structured interviews. Self-reported quality of life (QoL) and functional ability were assessed. Qualitative methods were used to identify themes associated with information giving and decision making. RESULTS: A total of 58/95 eligible women (61%) participated. Median age was 73 years (range 70-83). Mean total scores for QoL and functional ability were average. The majority of women preferred to make their treatment decisions collaboratively with a clinician (59%) or on their own (19%). The main reasons influencing decisions to accept chemotherapy were categorised as prevention of recurrence and clinician recommendation. Side effects, length of treatment, impact on QoL, low survival benefits and clinician recommendation influenced decisions to decline chemotherapy. The majority (80%) were satisfied with information provision, the communication with their clinician and explanation of treatment. CONCLUSIONS: Older women with EBC preferred to be involved in clinical decision making. Clinician recommendation plays a significant role in either accepting or declining chemotherapy. Well-informed decision making and effective communication between clinicians, older women and their family members are therefore important.
Authors: Matthew Castelo; Justin Lu; Lawrence Paszat; Zachary Veitch; Kuan Liu; Adena S Scheer Journal: Breast Cancer Res Treat Date: 2022-06-22 Impact factor: 4.624
Authors: Gary Ko; Julie Hallet; Katarzyna J Jerzak; Wing Chan; Natalie Coburn; Victoria Barabash; Frances C Wright; Nicole J Look Hong Journal: Ann Surg Oncol Date: 2022-10-18 Impact factor: 4.339
Authors: Allison Magnuson; Mina S Sedrak; Cary P Gross; William P Tew; Heidi D Klepin; Tanya M Wildes; Hyman B Muss; Efrat Dotan; Rachel A Freedman; Tracey O'Connor; William Dale; Harvey J Cohen; Vani Katheria; Anait Arsenyan; Abrahm Levi; Heeyoung Kim; Supriya Mohile; Arti Hurria; Can-Lan Sun Journal: J Clin Oncol Date: 2021-01-14 Impact factor: 44.544
Authors: Elizabeth Trice Loggers; Diana S M Buist; Laura S Gold; Steven Zeliadt; Rachel Hunter Merrill; Ruth Etzioni; Scott D Ramsey; Sean D Sullivan; Larry Kessler Journal: Int J Breast Cancer Date: 2016-07-25
Authors: Suzanne A Eccles; Eric O Aboagye; Simak Ali; Annie S Anderson; Jo Armes; Fedor Berditchevski; Jeremy P Blaydes; Keith Brennan; Nicola J Brown; Helen E Bryant; Nigel J Bundred; Joy M Burchell; Anna M Campbell; Jason S Carroll; Robert B Clarke; Charlotte E Coles; Gary J R Cook; Angela Cox; Nicola J Curtin; Lodewijk V Dekker; Isabel dos Santos Silva; Stephen W Duffy; Douglas F Easton; Diana M Eccles; Dylan R Edwards; Joanne Edwards; D Evans; Deborah F Fenlon; James M Flanagan; Claire Foster; William M Gallagher; Montserrat Garcia-Closas; Julia M W Gee; Andy J Gescher; Vicky Goh; Ashley M Groves; Amanda J Harvey; Michelle Harvie; Bryan T Hennessy; Stephen Hiscox; Ingunn Holen; Sacha J Howell; Anthony Howell; Gill Hubbard; Nick Hulbert-Williams; Myra S Hunter; Bharat Jasani; Louise J Jones; Timothy J Key; Cliona C Kirwan; Anthony Kong; Ian H Kunkler; Simon P Langdon; Martin O Leach; David J Mann; John F Marshall; Lesley Martin; Stewart G Martin; Jennifer E Macdougall; David W Miles; William R Miller; Joanna R Morris; Sue M Moss; Paul Mullan; Rachel Natrajan; James P B O'Connor; Rosemary O'Connor; Carlo Palmieri; Paul D P Pharoah; Emad A Rakha; Elizabeth Reed; Simon P Robinson; Erik Sahai; John M Saxton; Peter Schmid; Matthew J Smalley; Valerie Speirs; Robert Stein; John Stingl; Charles H Streuli; Andrew N J Tutt; Galina Velikova; Rosemary A Walker; Christine J Watson; Kaye J Williams; Leonie S Young; Alastair M Thompson Journal: Breast Cancer Res Date: 2013-10-01 Impact factor: 6.466