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Poster Session Abstracts

Abstract P2-10-03: Decision-making surrounding adjuvant chemotherapy in young women with early stage breast cancer

Shoshana M Rosenberg, Karen Sepucha, Kathryn J Ruddy, Lidia Schapira, Steven Come, Virginia Borges, Evan Morgan, Nancy U Lin, Shari Gelber, Rulla M Tamimi and Ann H Partridge
Shoshana M Rosenberg
Dana-Farber Cancer Institute
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Karen Sepucha
Massachusetts General Hospital
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Kathryn J Ruddy
Mayo Clinic
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Lidia Schapira
Massachusetts General Hospital
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Steven Come
Beth Israel Deaconess Medical Center
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Virginia Borges
University of Colorado
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Evan Morgan
Dana-Farber Cancer Institute
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Nancy U Lin
Dana-Farber Cancer Institute
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Shari Gelber
Dana-Farber Cancer Institute
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Rulla M Tamimi
Brigham and Women's Hospital
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Ann H Partridge
Dana-Farber Cancer Institute
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DOI: 10.1158/1538-7445.SABCS14-P2-10-03 Published May 2015
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Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium; December 9-13, 2014; San Antonio, TX

Abstract

Background: There is an increasing recognition that many young women with breast cancer will have favorable outcomes without chemotherapy. We sought to characterize decision-making surrounding adjuvant chemotherapy treatment (CT) in this population for whom chemotherapy has historically been a standard of care.

Methods: As part of an ongoing, multi-center, prospective cohort of young women diagnosed with breast cancer at age 40 and younger, we identified 657 women with Stage I-III breast cancer. Participants were asked to complete surveys by mail that included questions about socio-demographics, decision-making, and treatment history within the first year following diagnosis. Tumor characteristics were ascertained via pathology and medical record review. We used Chi-square tests to compare: decisional involvement (patient-driven vs. shared vs. physician-driven), degree of confidence, and feeling informed about the CT decision (the latter two measured on a 0-10 scale, categorized as follows: 0-5=low; moderate=6-8; 9-10=high) between women who did and did not receive CT. To explore clinical appropriateness of the CT decision, we used logistic regression to assess the relationship between tumor characteristics and non-receipt of CT among women with Stage I/II disease.

Results: Among women with Stage I (n=250), II (n=312), and III (n=95), disease, 66%, 95%, and 100%, received CT, respectively. A greater proportion of women who had CT were highly confident with their decision compared with women who did not have CT (80% vs. 60%, p<0.0001); women who did not have CT were more likely to report a low level of feeling informed about the CT decision compared to women who received CT (20% vs. 5%, p<0.0001). Women who did not have CT were also more likely to report the final CT decision as made by their doctor (49% vs. 28%) and less likely to report a shared decision (33% vs. 59%, p<0.0001). Non-receipt of CT in women with Stage I/II disease (n=546) was associated within having node negative disease, T1 (vs. T2 or larger), Her2- negative, and hormone receptor positive tumors.

Conclusion: Although non-receipt of CT would be expected to be viewed favorably by patients and doctors, we found that women who received CT felt more confident and better informed than those who received no CT. Given that women who did not have CT were also less likely to perceive the CT decision as shared, improved communication together with better decisional support may be beneficial, especially for women who do not receive adjuvant chemotherapy.

Citation Format: Shoshana M Rosenberg, Karen Sepucha, Kathryn J Ruddy, Lidia Schapira, Steven Come, Virginia Borges, Evan Morgan, Nancy U Lin, Shari Gelber, Rulla M Tamimi, Ann H Partridge. Decision-making surrounding adjuvant chemotherapy in young women with early stage breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-10-03.

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Cancer Research: 75 (9 Supplement)
May 2015
Volume 75, Issue 9 Supplement
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Abstract P2-10-03: Decision-making surrounding adjuvant chemotherapy in young women with early stage breast cancer
Shoshana M Rosenberg, Karen Sepucha, Kathryn J Ruddy, Lidia Schapira, Steven Come, Virginia Borges, Evan Morgan, Nancy U Lin, Shari Gelber, Rulla M Tamimi and Ann H Partridge
Cancer Res May 1 2015 (75) (9 Supplement) P2-10-03; DOI: 10.1158/1538-7445.SABCS14-P2-10-03

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Abstract P2-10-03: Decision-making surrounding adjuvant chemotherapy in young women with early stage breast cancer
Shoshana M Rosenberg, Karen Sepucha, Kathryn J Ruddy, Lidia Schapira, Steven Come, Virginia Borges, Evan Morgan, Nancy U Lin, Shari Gelber, Rulla M Tamimi and Ann H Partridge
Cancer Res May 1 2015 (75) (9 Supplement) P2-10-03; DOI: 10.1158/1538-7445.SABCS14-P2-10-03
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Poster Session Abstracts

  • Abstract P6-08-04: National trends in mastectomy for operable breast cancers treated with neoadjuvant chemotherapy
  • Abstract P6-15-12: A functional approach to the molecular basis of neoadjuvant treatment response in breast cancer
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Poster Session 2: Psychosocial, Quality of Life, and Educational Aspects: Doctor-Patient Communication

  • Abstract P2-10-04: Characterizing the metastatic breast cancer patient experience around preparing for a treatment decision
  • Abstract P2-10-02: Treatment adverse effect registration. A PC based electronic patient - hospital communication portal that allows registration of adverse effects of chemotherapy and returns advice and recommandations for action
  • Abstract P2-10-05: eHealth in modern breast cancer treatment: New possibilities in communication between patients, doctors and nursing staff
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Cancer Research Online ISSN: 1538-7445
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