Decision-support networks of women newly diagnosed with breast cancer

• Type of Material: Article
• Authors: Lauren P. Wallner, University of Michigan; Yun Li, University of Michigan; M. Chandler McLeod, University of Michigan; Ann S. Hamilton, University of Southern California; Kevin Ward, Emory University; Christine M. Veenstra, University of Michigan; Lawrence C. An, University of Michigan; Nancy K. Janz, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, University of Michigan
• Language: English
• Date: 2017-10-15
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 American Cancer Society
• Final Published Version (URL): http://dx.doi.org/10.1002/cncr.30848
• Title of Journal or Parent Work: Cancer
• ISSN: 0008-543X
• Volume: 123
• Issue: 20
• Start Page: 3895
• End Page: 3903
• Grant/Funding Information: Cancer incidence data collection was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP003862-04/DP003862; the NCI’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California (USC), and contract HHSN261201000034C awarded to the Public Health Institute.; Cancer incidence data collection in Georgia was supported by contract HHSN261201300015I, Task Order HHSN26100006 from the NCI and cooperative agreement 5NU58DP003875-04-00 from the CDC.; This work was funded by grant P01CA163233 to the University of Michigan from the National Cancer Institute and by grant RSG-14-035-01 from the American Cancer Society.
• Keywords: breast cancer study; CARE; CONTRALATERAL PROPHYLACTIC MASTECTOMY; DETERMINANTS; treatment decision making; informal decision support; caregivers; FAMILY; PERSPECTIVES; PARTICIPATION; SIGNIFICANT OTHERS; Life Sciences & Biomedicine; Science & Technology; Oncology; EXPERIENCES; breast cancer; INVOLVEMENT; decision-support networks; family
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Oncology; Health Sciences, Health Care Management

Abstract

BACKGROUND: Little is known about the size and characteristics of the decision-support networks of women newly diagnosed with breast cancer and whether their involvement improves breast cancer treatment decisions. METHODS: A population-based sample of patients newly diagnosed with breast cancer in 2014 and 2015, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries, were surveyed approximately 7 months after diagnosis (N = 2502; response rate, 68%). Network size was estimated by asking women to list up to 3 of the most important decision-support persons (DSPs) who helped them with locoregional therapy decisions. Decision deliberation was measured using 4 items assessing the degree to which patients thought through the decision, with higher scores reflecting more deliberative breast cancer treatment decisions. The size of the network (range, 0-3 or more) was compared across patient-level characteristics, and adjusted mean deliberation scores were estimated across levels of network size using multivariable linear regression. RESULTS: Of the 2502 women included in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years, and black women all were more likely to report larger network sizes (all P <.001). Larger support networks were associated with more deliberative surgical treatment decisions (P <.001). CONCLUSIONS: Most women engaged multiple DSPs in their treatment decision making, and involving more DSPs was associated with more deliberative treatment decisions. Future initiatives to improve treatment decision making among women with breast cancer should acknowledge and engage informal DSPs. Cancer 2017;123:3895-903. © 2017 American Cancer Society.