Psychosocial factors and patients' preferences for adjuvant chemotherapy in early breast cancer
Version of Record online: 19 JUL 2006
Copyright © 2006 John Wiley & Sons, Ltd.
Volume 16, Issue 1, pages 48–59, January 2007
How to Cite
Duric, V. M., Butow, P. N., Sharpe, L., Boyle, F., Beith, J., Wilcken, N. R.C., Heritier, S., Coates, A. S., John Simes, R. and Stockler, M. R. (2007), Psychosocial factors and patients' preferences for adjuvant chemotherapy in early breast cancer. Psycho-Oncology, 16: 48–59. doi: 10.1002/pon.1045
- Issue online: 27 DEC 2006
- Version of Record online: 19 JUL 2006
- Manuscript Accepted: 14 FEB 2006
- Manuscript Revised: 25 JAN 2006
- Manuscript Received: 14 OCT 2005
- National Health and Medical Research Council of Australia
- Cancer Council of Australia
- Australia New Zealand Breast Cancer Trials Group
- adjuvant chemotherapy;
- early breast cancer;
- patient preferences;
Purpose: Many women who have had adjuvant chemotherapy for early breast cancer judge small benefits sufficient to make it worthwhile despite significant side effects and inconvenience. The rationality of these preferences has been questioned. We sought to better understand such preferences by assessing associations between preferences and psychosocial factors, and by asking women who judged negligible benefits sufficient to explain why.
Methods: We recruited 83 consecutive consenting women who had completed adjuvant chemotherapy for early breast cancer 3–34 months earlier. Preferences were elicited during a structured, scripted interview using four sets of validated, hypothetical trade-off scenarios about the possible benefits of adjuvant chemotherapy on survival times (5 and 15 years) and rates (65 and 85% at 5 years). Women completed questionnaires measuring anxiety, depression, optimism, quality and quantity of social support, and illness perceptions.
Results: More than half the women judged benefits of 1 day or 0.1% sufficient to make adjuvant chemotherapy worthwhile. The most important factors in multivariable models were whether the woman had dependants and number of non-specific symptoms attributed to breast cancer and adjuvant chemotherapy since completing treatment. The proportion of variance explained was modest. Preferences were not associated with: scores for anxiety, optimism, and perceived quality and quantity of social support. Explanations for judging negligible benefits sufficient included minimising regret, parenting concerns, doubts about the information provided and feeling that they had no choice.
Conclusions: Preferences were highly variable and influenced by women's unique circumstances and attitudes, but not by their anxiety or optimism scores. Copyright © 2006 John Wiley & Sons, Ltd.