Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
A BEDSIDE DECISION INSTRUMENT FOR ADJUVANT CHEMOTHERAPY IN EARLY BREAST CANCER (MEETING ABSTRACT)
Proc Annu Meet Am Soc Clin Oncol; 11:A94 1992. Unique Identifier : AIDSLINE ICDB/92680825 Levine M; Gafni A; Markham B; MacFarlane D; McMaster Univ., Hamilton, Canada
Abstract:
The decision facing the patient (pt) with node-negative breast cancer to receive or not receive adjuvant chemotherapy is a difficult one. She must trade off potential immediate decrease in quality of life with the potential future decrease in recurrence of breast cancer. Recent studies indicate that many breast cancer pts do not understand the information concerning adjuvant treatment (Rx) presented to them by their physicians. The objective of our research was to develop an instrument to help clinicians transfer information derived from clinical trials on risks and benefits of adjuvant chemotherapy to pts and to help the informed pt elicit a preference for Rx or no Rx. The instrument consists of a visual aid prop (called the decision board) and written material. Its validity and reliability were evaluated in 30 healthy female volunteers. At first, it was administered using standard estimates of recurrence for node-negative breast cancer (ie, without Rx, a 15% risk of recurrence, which is reduced to 10% with chemotherapy). A preference for Rx (or no Rx) was then elicited. Validity was evaluated by changing the information provided on risks and benefits and determining whether the preference changed in a predictable manner. To test for reliability, the instrument was administered 2 wk later. Seventeen women chose chemotherapy, and 13 chose no chemotherapy. In the former group, 14 women (82%) switched preference when the magnitude of benefit was reduced, and 16 (94%) switched when the toxicity of Rx was increased. For those women who chose not to receive chemotherapy, 12 (92%) switched when the benefit was increased and 100% switched when toxicity was eliminated. The reliability was excellent, kappa = 0.86. The instrument has recently been used to elicit Rx preferences in 20 newly presenting high-risk node-negative breast cancer pts, and has been found to be acceptable and helpful to the pt. In conclusion, a valid, reliable instrument for eliciting pt preferences concerning chemotherapy or no chemotherapy in node-negative breast cancer has been established.
Keywords: Audiovisual Aids Breast Neoplasms/*DRUG THERAPY/PATHOLOGY/*PSYCHOLOGY/SURGERY Combined Modality Therapy *Decision Making Female Human Lymphatic Metastasis *Patient Education Quality of Life Risk Factors ABSTRACT 921030
M92A1030
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Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
