Decision making, decision regret and patient preferences in pre-menopausal women with low-risk early breast cancer. — ASN Events

Decision making, decision regret and patient preferences in pre-menopausal women with low-risk early breast cancer. (#836)

Laura Emery 1 , Christobel M Saunders 1
  1. University of Western Australia, NEDLANDS , WA, Australia

Introduction: While treatment advances mean many breast cancer patients can expect to be long term survivors, quality of life after treatment is important including potential loss of fertility.[1] Premenopausal women, particularly those with hormone dependent cancer thus a variety of treatment options, need to weigh up potential survival benefits against treatment side effects.[2]

To date no studies have evaluated a comprehensive set of factors around the treatment of young women with low risk early breast cancer which includes decision making, decision regret, patient preferences, side effects and disease outcomes.

Methods: This is a prospective study looking at treatment preferences, decision making, decision regret, patient preferences, side effects and disease outcome in pre-menopausal women under 47 years with low-risk early breast cancer.

Recruitment is across multiple sites in Australia and eligible patients are invited to participate after they have chosen their treatment (including endocrine therapy alone or with chemotherapy).

Results: With 6 participants lost to follow-up or declining to participate further, this paper focuses on the decision making, decision regret and patient preferences of 28 participants (15 chemotherapy; 13 Goserelin). One of the validated tools used measured decision conflict with 10 respondents preferring chemotherapy; 11 goserelin and 4 suggesting they were unsure at the time of undertaking treatment. Nearly half (47%) of the respondents were strongly aware of the benefits of their chosen treatment, with less respondents strongly agreeing about their knowledge of the risks and side effects (44%). Two (7%) respondents strongly disagreed about this ‘being an easy decision to make’. Overall, only 38% strongly agreed they were satisfied with their decision.

Conclusion & recommendations: This research will provide relevant data to assist younger women to make informed evidence based decisions regarding treatments taking into consideration quality of life, side effects, survival and the impact of treatments on subsequent fertility.

  1. Petrek J, et al. Incidence, Time Course, and Determinants of Menstrual Bleeding After Breast Cancer Treatment: A Prospective Study. Journal of Clinical Oncology, 2006. 24(7):1045-1051.
  2. Thewes B, et al. What survival benefits do premenopausal patients with early breast cancer need to make endocrine therapy worthwhile? The Lancet Oncology, 2005. 6(8):581-88.