Estimation of Risk of Recurrence and Toxicity Among Oncologists and Patients With Resected Breast Cancer: A Quantitative Study

Frontiers in Psychology

article

Laura Ciria-Suarez¹  Paula Jimenez-Fonseca²  Raquel Hernández³  Jacobo Rogado⁴  Caterina Calderon¹ 

[1] Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona;Department of Medical Oncology, Central University Hospital of Asturias;Department of Medical Oncology, Canary University Hospital;Department of Medical Oncology, Infanta Leonor University Hospital

关键词: breast cancer;    chemotherapy;    prognosis;    shared decision making;    toxicity;   

DOI  :  10.3389/fpsyg.2020.540083

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Shared decision-making regarding adjuvant systemic therapy in breast cancer is based on both properly conveying information about the prognosis of the disease and the benefits and risks of adjuvant treatment, as well as the patient’s ability to understand this information. This work proposed to analyze oncologists’ and patients’ perceptions of the risk of recurrence with and without chemotherapy and toxicity, and the factors influencing said impressions. This was a prospective, cross-sectional, multicenter study that involved 281 breast cancer patients and 23 oncologists. Prognosis (risk of recurrence with and without chemotherapy and risk of severe toxicity with chemotherapy) and shared decision making (SDM) questionnaires were completed by all participants; breast cancer patients also filled out the 18-item Brief Symptom Inventory (BSI-18). Oncologists’ prediction of risk of relapse without and with chemotherapy (30.4 and 13.3%) and risk of severe toxicity (9.8%) were more optimistic than those of breast cancer patients (78.6, 29.6, and 61%, respectively). The greater the severity, the higher the risk of relapse according to the oncologists ( p = 0.001); not so for the patients. Older physicians and more experienced ones predicted lower risk of relapse with and without chemotherapy and less severe toxicity than younger doctors and those with less experience ( p < 0.001). Oncologists’ SDM and their prediction of risk of relapsing with chemotherapy correlated negatively with patients’ SDM and their prediction of risk of severe toxicity ( p < 0.01). There is a positive correlation between psychological distress (BSI-18) and prognosis of risk of recurrence with chemotherapy in breast cancer patients ( p < 0.001). These results stress the importance of improving doctor–patient communication in SDM. In breast cancer patients undergoing treatment with curative intent, expectations of being cured would increase and treatment-related anxiety would decrease by enhancing doctor–patient communication to coincide more with respect to risk of relapse and toxicity, thereby enhancing patients’ quality of life.

【 授权许可】

CC BY