Maria Burton1, Karen Anna Collins1, Kate Joanna Lifford2, Kate Brain2, Lynda Wyld3, L Caldon4, Jacqui Gath5, Deirdre Revell5, Malcolm William Reed6. 1. Sheffield Hallam, University Centre for Health and Social Care Research Montgomery House, Sheffield, South Yorkshire, United Kingdom. 2. Cardiff University, Institute of Primary Care and Public Health, School of Medicine, Cardiff, United Kingdom. 3. University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom. 4. University of Sheffield, Sheffield, United Kingdom. 5. North Trent Cancer Network Consumer Research Panel, Sheffield, United Kingdom. 6. University of Sheffield, Academic Surgical Oncology Unit, Sheffield, United Kingdom.
Abstract
OBJECTIVE: Primary Endocrine Therapy (PET) is a good alternative to surgery for breast cancer in older frailer women. Overall survival rates are equivalent although rates of local control are inferior. There is little research regarding the decision support needs of older patients faced with this choice. This qualitative study aimed to explore these among older breast cancer patients offered a choice of treatment, as the basis to develop an appropriate decision support tool. METHODS: Semi-structured interviews were undertaken with older women (>75 years) with breast cancer who had been offered a choice of PET or surgery at diagnosis. Women's involvement in their treatment decision and support for the process were explored and analysed using framework analysis. RESULTS: Thirty-three interviews were undertaken (median age 82, range 75-95 years, 22 PET, 11 surgery). Most women, regardless of treatment choice, wanted tailored information about the different treatment options, their impact on independence, the practicalities of treatment and the risk of recurrence and spread. Surgery was the treatment of choice in women wanting optimal disease control; those choosing PET felt that they were 'too old' for surgery and wanted minimal disruption. CONCLUSIONS: Older women described making active treatment decisions. However, some knowledge was inaccurate. Women wanted information and decision support from their clinicians along with a specific tailored information booklet to support this process.
OBJECTIVE: Primary Endocrine Therapy (PET) is a good alternative to surgery for breast cancer in older frailer women. Overall survival rates are equivalent although rates of local control are inferior. There is little research regarding the decision support needs of older patients faced with this choice. This qualitative study aimed to explore these among older breast cancer patients offered a choice of treatment, as the basis to develop an appropriate decision support tool. METHODS: Semi-structured interviews were undertaken with older women (>75 years) with breast cancer who had been offered a choice of PET or surgery at diagnosis. Women's involvement in their treatment decision and support for the process were explored and analysed using framework analysis. RESULTS: Thirty-three interviews were undertaken (median age 82, range 75-95 years, 22 PET, 11 surgery). Most women, regardless of treatment choice, wanted tailored information about the different treatment options, their impact on independence, the practicalities of treatment and the risk of recurrence and spread. Surgery was the treatment of choice in women wanting optimal disease control; those choosing PET felt that they were 'too old' for surgery and wanted minimal disruption. CONCLUSIONS: Older women described making active treatment decisions. However, some knowledge was inaccurate. Women wanted information and decision support from their clinicians along with a specific tailored information booklet to support this process.
Authors: Eida M Castro; Gloria Asencio; Gwendolyn P Quinn; Thomas Brandon; Clement K Gwede; Susan Vadaparampil; Vani Simmons; Jessica McIntyre; Julio Jiménez Journal: P R Health Sci J Date: 2017-12 Impact factor: 0.705
Authors: Maria Burton; Kate J Lifford; Lynda Wyld; Fiona Armitage; Alistair Ring; Anthony Nettleship; Karen Collins; Jenna Morgan; Malcolm W R Reed; Geoffrey R Holmes; Mike Bradburn; Jacqui Gath; Tracy Green; Deirdre Revell; Kate Brain; Adrian Edwards Journal: Trials Date: 2021-07-13 Impact factor: 2.279
Authors: Kate J Lifford; Jana Witt; Maria Burton; Karen Collins; Lisa Caldon; Adrian Edwards; Malcolm Reed; Lynda Wyld; Kate Brain Journal: BMC Med Inform Decis Mak Date: 2015-06-10 Impact factor: 2.796
Authors: Stephanie B Wheeler; Megan C Roberts; Diane Bloom; Katherine E Reeder-Hayes; Maya Espada; Jeffrey Peppercorn; Carol E Golin; Jo Anne Earp Journal: Patient Prefer Adherence Date: 2016-09-30 Impact factor: 2.711
Authors: Karen Collins; Malcolm Reed; Kate Lifford; Maria Burton; Adrian Edwards; Alistair Ring; Katherine Brain; Helena Harder; Thompson Robinson; Kwok Leung Cheung; Jenna Morgan; Riccardo Audisio; Susan Ward; Paul Richards; Charlene Martin; Tim Chater; Kirsty Pemberton; Anthony Nettleship; Christopher Murray; Stephen Walters; Oscar Bortolami; Fiona Armitage; Robert Leonard; Jacqui Gath; Deirdre Revell; Tracy Green; Lynda Wyld Journal: BMJ Open Date: 2017-07-31 Impact factor: 2.692