Alison S Baskin1, Ton Wang2,3, Nicole M Mott1, Sarah T Hawley4, Reshma Jagsi4,5, Lesly A Dossett6,7. 1. University of Michigan Medical School, Ann Arbor, MI, USA. 2. Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA. 3. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. 4. Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA. 5. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA. 6. Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA. ldossett@med.umich.edu. 7. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. ldossett@med.umich.edu.
Abstract
BACKGROUND: For women older than 70 years with early-stage breast cancer, the routine use of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy offers no overall survival benefit and may be perceived as undesirable by many women. National guidelines allow possible omission of these practices for older women. This study aimed to assess the availability of web-based educational materials targeting older women and their age-specific treatment recommendations. METHODS: The study systematically assessed the websites of the top 25 "Best Hospitals for Cancer" ranked by the U.S. News & World Report, as well as the websites of four prominent national cancer organizations. RESULTS: Websites for the leading cancer hospitals and national cancer organizations contain extremely limited information directed toward older patients with breast cancer. Both SLNB and adjuvant radiotherapy are described as treatments "typically," "most often," or "usually" used in combination with breast-conserving surgery without circumstances noted for possible omission. Specifically, no hospital website and only one national organization in this study included information on the recommendation to avoid routine SLNB. Only two hospitals and two national organizations included information suggesting possible omission of adjuvant radiotherapy for patients older than 70 years. CONCLUSION: The absence of online material for older patients with breast cancer represents a gap potentially contributing to overtreatment by framing SLNB and adjuvant radiotherapy as necessary. Informational resources available to women aged 70 years or older may aid in informed physician-patient communication and decision-making, which may reduce SLNB and adjuvant radiotherapy for patients who might opt out of these procedures if fully informed about them.
BACKGROUND: For women older than 70 years with early-stage breast cancer, the routine use of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy offers no overall survival benefit and may be perceived as undesirable by many women. National guidelines allow possible omission of these practices for older women. This study aimed to assess the availability of web-based educational materials targeting older women and their age-specific treatment recommendations. METHODS: The study systematically assessed the websites of the top 25 "Best Hospitals for Cancer" ranked by the U.S. News & World Report, as well as the websites of four prominent national cancer organizations. RESULTS: Websites for the leading cancer hospitals and national cancer organizations contain extremely limited information directed toward older patients with breast cancer. Both SLNB and adjuvant radiotherapy are described as treatments "typically," "most often," or "usually" used in combination with breast-conserving surgery without circumstances noted for possible omission. Specifically, no hospital website and only one national organization in this study included information on the recommendation to avoid routine SLNB. Only two hospitals and two national organizations included information suggesting possible omission of adjuvant radiotherapy for patients older than 70 years. CONCLUSION: The absence of online material for older patients with breast cancer represents a gap potentially contributing to overtreatment by framing SLNB and adjuvant radiotherapy as necessary. Informational resources available to women aged 70 years or older may aid in informed physician-patient communication and decision-making, which may reduce SLNB and adjuvant radiotherapy for patients who might opt out of these procedures if fully informed about them.
Authors: Kimra Castleton; Thomas Fong; Andrea Wang-Gillam; Muhammad A Waqar; Donna B Jeffe; Lisa Kehlenbrink; Feng Gao; Ramaswamy Govindan Journal: Support Care Cancer Date: 2010-06-18 Impact factor: 3.603
Authors: William J Gradishar; Benjamin O Anderson; Ron Balassanian; Sarah L Blair; Harold J Burstein; Amy Cyr; Anthony D Elias; William B Farrar; Andres Forero; Sharon Hermes Giordano; Matthew Goetz; Lori J Goldstein; Clifford A Hudis; Steven J Isakoff; P Kelly Marcom; Ingrid A Mayer; Beryl McCormick; Meena Moran; Sameer A Patel; Lori J Pierce; Elizabeth C Reed; Kilian E Salerno; Lee S Schwartzberg; Karen Lisa Smith; Mary Lou Smith; Hatem Soliman; George Somlo; Melinda Telli; John H Ward; Dorothy A Shead; Rashmi Kumar Journal: J Natl Compr Canc Netw Date: 2016-03 Impact factor: 11.908
Authors: Lauren P Wallner; Yun Li; M Chandler McLeod; Ann S Hamilton; Kevin C Ward; Christine M Veenstra; Lawrence C An; Nancy K Janz; Steven J Katz; Sarah T Hawley Journal: Cancer Date: 2017-06-22 Impact factor: 6.921
Authors: Lesly A Dossett; Nicole M Mott; Brooke C Bredbeck; Ton Wang; Chad Tc Jobin; Tasha M Hughes; Sarah T Hawley; Brian J Zikmund-Fisher Journal: J Surg Res Date: 2021-11-19 Impact factor: 2.192
Authors: Luis Chang-Azancot; Pedro Abizanda; María Gijón; Nitzan Kenig; Manuel Campello; Jessica Juez; Antonio Talaya; Gregorio Gómez-Bajo; Javier Montón; Rodrigo Sánchez-Bayona Journal: Aesthetic Plast Surg Date: 2022-08-04 Impact factor: 2.708