Accuracy of Perceived Risk of Recurrence Among Patients With Early-Stage Breast Cancer

Liu, Ying; Pérez, María; Aft, Rebecca; Massman, Kerry; Robinson, Erica; Myles, Stephanie; Schootman, Mario; Gillanders, William E.; Jeffe, Donna B.

doi:10.1158/1055-9965.epi-09-1051

Cited by 45 publications

(54 citation statements)

References 24 publications

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“…Our finding of higher education being significantly associated with UO is consistent with that of studies of the general population (Waters et al, 2011), though another study in which sampling occurred in a clinical setting yielded no association (Liu et al, 2010). We were not able to identify any study directly addressing the relationship between marital status and breast cancer misperception of risk.…”

Section: Discussionsupporting

confidence: 89%

Correlates of misperception of breast cancer risk among Korean-American Women

2015

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This study investigated the factors associated with misperception of breast cancer risk, including unrealistic optimism and unrealistic pessimism, among Korean-American women (KAW). Baseline data were collected between March 2010 and October 2011 from 421 KAW aged 40–65 years who participated in a community-based randomized intervention trial designed to promote breast and cervical cancer screening. Multivariate multinomial regression was performed to identify correlates of misperception of breast cancer risk among KAW. A total of 210 KAW (49.9%) had breast cancer risk perception consistent with their objective risk, whereas 50.1% of KAW in the study had some form of misperception of risk. Specifically, 167 participants (39.7%) were unrealistically optimistic about their own breast cancer risk; 44 (10.5%) were unrealistically pessimistic. In multivariate multinomial logistic regression analysis, living with a partner and higher education were significantly associated with higher odds of having unrealistic optimism. High social support was associated with a lower likelihood of having a pessimistic risk perception. Higher worry was associated with a higher likelihood of having unrealistic pessimism. Misperception of breast cancer risk among KAW and related factors must be considered when developing behavioral interventions for this population.

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Section: Discussionsupporting

confidence: 89%

Correlates of misperception of breast cancer risk among Korean-American Women

2015

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“…(4) However most women with early stage breast cancer overestimate their risk of breast cancer recurrence (42), as well as the risk of developing a new cancer in the opposite breast.. (43) While mastectomy rates for early stage breast cancer fell between 1995 and 2005, in recent years rates of both unilateral mastectomy and bilateral mastectomy have been increasing steadily. (44,45) Increasing use of bilateral mastectomy in the case where there is no contralateral breast cancer present is increasingly drawing attention for being a possible problem of overuse..…”

Section: Discussionmentioning

confidence: 99%

Decision Regret following Treatment for Localized Breast Cancer

Martinez

Resnicow

et al. 2014

Med Decis Making

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Background While studies suggest most women have little regret regarding their breast cancer treatment decisions immediately following treatment, to date no studies have evaluated how regret may change over time. Objective To measure the stability of post-treatment decision regret over time among women with breast cancer. Methods Women diagnosed with breast cancer between August 2005 and May 2007 reported to the Detroit, Michigan or Los Angeles County Surveillance Epidemiology and End Results (SEER) registry completed surveys at 9 months following diagnosis (Time 1) and again approximately 4 years later (Time 2). A decision regret scale consisting of 5 items was summed to create two decision regret scores at both Time 1 and Time 2 (range: 0 to 20). Multivariable linear regression was used to examine change in regret from 9 months to 4 years. Independent variables included surgery type, receipt of reconstruction, and recurrence status at follow-up. The model controlled for demographic and clinical factors. Results The analytic sample included 1,536 women. Mean regret in the overall sample was 4.9 at Time 1 and 5.4 at Time 2 (p<0.001). In the multivariable linear model, we found no difference in change in decision regret over time by surgery type. Reporting a new diagnosis of breast cancer at Time 2 was associated with 2.6 point increase in regret over time, compared to women without an additional diagnosis (p=0.003). Receipt of reconstruction was not associated with change in decision regret over time. Conclusions Decision regret following treatment was low and relatively stable over time for most women. Those facing an additional diagnosis of breast cancer following treatment may be at risk for elevated regret-related distress.

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“…[2-4] Yet, understanding and interpreting risk, is challenging, and studies have found that many women with breast cancer significantly overestimate their risk of distant recurrence after treatment. [5-8]…”

Section: Introductionmentioning

confidence: 99%

Recurrence risk perception and quality of life following treatment of breast cancer

Hawley

Janz

Griffith

et al. 2016

Breast Cancer Res Treat

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Purpose Little is known about different ways of assessing risk of distant recurrence following cancer treatment (e.g., numeric or descriptive). We sought to evaluate the association between overestimation of risk of distant recurrence of breast cancer and key patient reported outcomes, including quality of life and worry. Methods We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer identified through SEER registries of Los Angeles & Georgia (2013-14) ∼2 months after surgery (N=2578, RR=71%). Actual 10-year risk of distant recurrence after treatment was based on clinical factors for women with DCIS & low risk invasive cancer (Stg 1A, ER+HER2-, Gr 1-2). Women reported perceptions of their risk numerically (0 – 100%), with values ≥10% for DCIS & ≥20% for invasive considered overestimates. Perceptions of “moderate, high or very high” risk were considered descriptive overestimates. In our analytic sample (N=927), we assessed factors correlated with both types of overestimation and report multivariable associations between overestimation and QoL (PROMIS physical & mental health) and frequent worry. Results 30.4% of women substantially overestimated their risk of distant recurrence numerically and 14.7% descriptively. Few factors other than family history were significantly associated with either type of overestimation. Both types of overestimation were significantly associated with frequent worry, and lower QoL. Conclusions Ensuring understanding of systemic recurrence risk, particularly among patients with favorable prognosis, is important. Better risk communication by clinicians may translate to better risk comprehension among patients and to improvements in QoL.

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Accuracy of Perceived Risk of Recurrence Among Patients With Early-Stage Breast Cancer

Cited by 45 publications

References 24 publications

Correlates of misperception of breast cancer risk among Korean-American Women

Correlates of misperception of breast cancer risk among Korean-American Women

Decision Regret following Treatment for Localized Breast Cancer

Recurrence risk perception and quality of life following treatment of breast cancer

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