Breast Cancer Coverage from Every Angle

Quality Care 2019: Chemotherapy Decisions of Older Women With Early-Stage Breast Cancer

By: Anna Nowogrodzki
Posted: Friday, September 27, 2019

Both anecdotal experiences and values often affect older women’s treatment decisions regarding early-stage breast cancer, according to a poster presented at the 2019 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 181). The research was conducted by Meghan Sri Karuturi, MD, MSc, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues.

“Decision-making strategies in older patients were shaped by knowledge, values, and the anecdotal experience of others,” the authors wrote.

The investigators performed semistructured interviews with 26 women between the ages of 65 and 92 at an academic medical center. They asked the women about their decisions about whether to receive neo/adjuvant chemotherapy. All of the women had been diagnosed with early stage (I–III) breast cancer. Of the women, 81% were non-Hispanic white, and 81% had at least a college degree.

A total of 14 patients decided to seek chemotherapy treatment, and 11 patients did not. Most had adequate health literacy and numeracy, according to the surveys they completed.

The interviews revealed that patients often made treatment decisions that did not follow their physician’s recommendation, citing their friends or family members’ experience with cancer as a reason. Important factors in decision-making included patients’ perception of their own health and chemotherapy side effects. Patients valued quality of life and were sometimes confused about the objective of chemotherapy.

The authors intend to use the results to create a decision facilitation tool that physicians and older patients can use together to navigate the decision-making process.

Disclosure: Dr. Karuturi has served as a consultant or advisor to MD Anderson Physicians Network and Pfizer. The other study authors reported no conflicts of interest.

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